Dilated Cardiomyopathy Case Study

Hypertrophic cardiomyopathy is an inherited autosomal-dominant pattern affecting nearly 1 in 500 people, affecting both men and women equally. Which makes it the most “common genetic heart disease in the United States” [5] Many studies have been done on the causes of this disease. Research has shown the mutations of between 10 to 13 sarcomeric proteins are associated with HCM. Each mutated gene has a different pathological characteristic.

As this disease progresses and the workload of the heart is consistently increased, ventricular hypertrophy occurs. At first, the hypertrophied heart muscles will increase contractility, thus increasing cardiac output; however, as hypertrophy of the ventricular myocardial cells continues, it begins to have poor contractility, requires more oxygen to perform, and has poor circulation from the coronary arteries. This can result in heart tissue ischemia and lead into cardiac dysrhythmias (Lewis et al. 2014, 768).

Stem cells have made significant promise to help people understand and treat a broad range of injuries, diseases, and other health-related issues. This type of treatment has saved the lives of many people with leukemia and can also be used for tissue grafts to treat conditions with the skin, bone and surface of the eye ("Nine Things to Know about Stem Cell Treatments"). Dilated cardiomyopathy (DMC) is a disease characterized by expansion of the left ventricular chamber and it is usually associated with systolic dysfunction. The presentations of the condition include heart failure, myocardial infarction, and arrhythmia and as a refractory life-threatening condition which can cause heart failure, transplantation remains the ultimate therapy for

Through more research, dilated cardiomyopathy has been found to have a genetic component (MacRae, 2010). Though there have been families who have volunteered to be screened, there are still some 40 chromosomal loci and potential disease genes discovered so far. The reason for the wide range of variants of potential loci is due to how prevalent the disease is in families. For example, the more individuals who have been diagnosed with the disease, researchers were then able to find similar loci among the affected; whereas, the families who had fewer affected individuals laid a wider range of

One of the main causes of mortality and morbidity is congestive heart failure (CHF). The major causes of CHF are coronary artery disease and hypertension. Other risk factors are occurrence of left ventricular hypertrophy (LVH), valvular heart disease, diabetes, smoking, obesity and dyslipidemia [46, 47]. Diabetes mellitus as an anticipated factor of CHF was explained in some studies [44, 47]. Diabetes is considered as a risk factor for CHF but yet, its relationship with CHF has not been completely understood [47, 48]. Alterations of left ventricular function and structure that are associated with diabetes mellitus or diminished glucose regulation have been described in recent studies [42, 49]. It has been reported that insulin resistance

The major causes of diastolic heart failure are hypertension-induced myocardial hypertrophy and myocardial ischemia-induced ventricular transformation (coronary artery disease). Hypertrophy and ischemia cause a decreased ability of the myocytes to actively pump calcium from the cytosol, resulting in impaired relaxation. Some of the other causes are aortic valvular disease and cardiomyopathies. Diabetes can also lead to diastolic heart failure (Huether and McCune 2012). Other risk factors for this disease are chronic kidney disease, obstructive sleep apnea, and older age. There are two types of the heart failure: systolic heart failure and diastolic heart failure. In systolic heart failure, the left ventricle has difficulty contracting and ejecting blood into the circulation, which causes reduced left ventricular fraction. On the other hand, diastolic heart failure has a slow and delayed relaxation and increased chamber rigidity, which then causes inadequate filling of blood and

Congestive cardiac failure (CCF) is a progressive disease of the heart, which involves loss of pumping ability by the heart. Congestive cardiac failure occurs when the myocardium loses its ability to pump enough blood to meet the body’s metabolic needs and is generally accompanied by fluid accumulation in the body tissues, especially the lungs. The build–up of fluid affects the normal function of the heart, pulmonary circulation, blood pressure, the distribution of oxygen and nutrients, and

Risk for having CAD or established CAD, previous MI or heart failure with decreased ejection fraction and ventricular arrhythmias are the known risk factors for SCD[17, 136]. The estimated incidence rate of SCD in infants, children, adolescents, and young adults is about 1.3 to 8.5 per 100,000 patient/years [137] but it still costs to thousands life per year. Sudden infant death syndrome accounting for approximately 10% of the crib death is believed to be due to cardiac arrhythmia or long QT syndrome [138]. A study suggest that out of 158 deaths of American athletes, 30% were due to hypertrophic cardiomyopathy and 13% due to abnormal blood circulation, 10% due to increased cardiac mass due to cardiomyopathy [139]. Another study suggest 20% death due to CAD and 10% deaths due to right ventricular cardiomyopathy/ dysplasia in young population [140]. Patients suffering from SCD with normal heart or without any cardiac disease history, on autopsy show structural abnormalities. Sudden unexplained deaths are also a major concern in epidemiology of SCD and careful post-mortem and histological examination can play a vital role [17]. In a study with 270 autopsies 55 were found to have structural heart disease and a specific cause for death were found in 180 cases with 65% having CAD, 14% with congenital anomalies and 11% with myocarditis. Left

Research by the American Heart Association (2014) states that heart failure effects an estimated 5.1 million Americans and it is predicted to increase 25% by 2030. Heart failure is a pathophysiological condition that indicates the heart is unable to promote enough cardiac output causing insufficient blood supply to the body. Pharmacological treatment for cardiac failure is dependent upon the ability to decrease rate of blood flow and blood pressure. Survival after heart failure diagnosis has improved with medication but the death rate remains high with over half of the people diagnosed with heart failure will die within 5 years. (Go et al., 2014)

“Following The Trail of Broken Hearts” by David Epstein published on December 10, 2007 really opens your eyes to the fact that there are more medical problems then sometimes we think or know about. We hear about the big ones like cancer, diabetes, and high cholesterol but, what about the not well known diseases that are taking more lives than other diseases combined? This article opens up and recognizes one of those diseases, HCM or Hypertrophic cardiomyopathy.

Heart failure is a complex clinical syndrome in which the heart is unable to pump sufficient amounts of blood to meet the body’s metabolic demands. Specifically, the left side of the heart receives oxygen rich blood from the pulmonary veins and is responsible for systemic oxygenation by pumping this blood through the aorta to the rest of body. The left ventricle provides most of the heart’s pumping power; it has a thick muscular wall . When the left ventricle weakens and becomes inefficient in its ability to…. the left side

According to the US Census Bureau, population estimates in 2004, in the United States it is estimated that approximately .02% of the population is effected by hypertrophic cardiomyopathy. Which is two in

The patient’s chart did not state which type of cardiomyopathy he had a history of, but there are four types of cardiomyopathies. Dilated cardiomyopathy is when both heart ventricles are dilated and the heart’s pumping function is impaired because the ventricular walls stretch out to very thin widths (Dechant, 2016). Hypertrophic cardiomyopathy is where the walls of the ventricles thicken and grow inwards, and could impair the outflow of blood when the heart contracts (Dechant, 2016). Restrictive cardiomyopathy is when the ventricles stiffen in elasticity, restricting the inflow of blood into the ventricles at rest (Dechant, 2016). Finally, arrhythmogenic right ventricular cardiomyopathy could involve either ventricle and is when the myocardial tissue is replaced by fatty tissue, impairing overall ventricular function (Dechant, 2016).

A fine line exists between the harmless enlargement of athlete’s heart and the harmful consequences of HCM. Found in 1/500 individuals, HCM causes a “thickened septum which separates the left and right ventricles” (“Causes of Sudden Cardiac Death”). The myofibrils, the “contractile elements of the heart,” lose their proper orientation and become disorganized, causing the heart to beat ineffectively and leading to the thickening of the walls and structural issues. The thickness can limit flow to the heart and lead to arrhythmias and sudden cardiac death (“Causes of Sudden Cardiac Death”). In both HCM and athlete’s heart the left ventricle thickens; however the wall hypertrophy in HCM may extend to more than 20mm, compared to less than 16mm in athlete’s heart (Maron, Pelliccia, and Spirito). Careful analysis of echocardiographic and clinical features almost always “permits this diagnostic differentiation” (Maron, Pelliccia, and Spirito). As mentioned before, left ventricular end-diastolic cavity dimensions greater than 55mm are not uncommon in trained athletes, yet the diastolic cavity dimension remains small (55mm, making it possible to distinguish athlete’s heart from HCM based on cavity measurement and borderline wall thickness (Maron, Pelliccia, and Spirito). However, ECGs, due to their wide variance, cannot provide sufficient evidence to distinguish between the two heart conditions (Maron, Pelliccia, and Spirito). Although there are numerous methods to distinguish and diagnose HCM, it remains the leading cause of sudden cardiac death (SCD) among

Hypertrophic cardiomyopathy is characterized by interventricular septal hypertrophy (in absence of other cardiovascular conditions), causing decrease of left ventricle cavity and potentially leading to outflow obstruction. (1) (6) As a consequence of mutations in several genes encoding for thick and thin filaments which build the cardiac muscle, morphological changes occur leading to tangled, thickened myocardial fibers. It is an important cause of morbidity and mortality. Symptomatology varies a lot, from asymptomatic patients to those with severe cardiac function impairment. Some of the most common symptoms of HCM, which are not specific to this disorder may be: shortness of breath at rest or with exertion, fatigue, chest pain, arrhythmias, dizziness, but not only.