Hypertrophic Cardiomyopathy Case Study

Hypertrophic cardiomyopathy is an inherited disease that affects the cardiac muscle of the heart, causing the walls of the heart to thicken and become stiff. [1] On a cellular level, the sarcomere

A 54 year old female with a history of ischemic cardiomyopathy with stage D heart failure requiring home milrinone therapy. She presented to our hospital with progressive shortness of breath, orthopnea, and pitting lower extremity edema despite home milrinone. She was admitted to the cardiac intensive care unit where LVAD work-up was initiated. She was deemed an appropriate candidate for an LVAD placement and had the HeartMate II LVAD placed. Aside from one episode of atrial fibrillation with rapid ventricular response her postoperative course was uneventful. She was anti-coagulated and taken off milrinone postoperatively. Two weeks after her procedure, she started to complain of difficulty opening her eyes, double vision, she had no weakness

Takotsubo cardiomyopathy was first acknowledged in Japan in 1990 by Sato et al (Djuric 512). The United States did not have any report of Takotsubo until 1998 (Sharkey e460). Since 1998, scientific interest in Takotsubo has steadily increased. Dr. Scott Sharkey validates the increase in scientific interest: “In 2000, only 2 publications were recorded, compared with nearly 300 in 2010. Now, takotsubo is widely recognized, with reports form 6 continents and diverse countries” (e460).

Fackelmann, Kathleen. "Flaws of the heart; sudden death in athletes is often caused by cardiac defects." Science News 3 Aug. 1996: 76+. Academic OneFile. Web. 27 Oct. 2015.

In cardiomyopathy the heart muscle becomes enlarged, thick or rigid, and in rare cases the muscle tissue can be replaced with scar tissue. As this disease worsens, the heart becomes weaker and unable to pump blood normally through the body and maintain a normal electrical rhythm. This can lead to heart failure or irregular heartbeats. The weakening of the heart also can lead to other problems such as heart valve problems. Cardiomyopathy can be acquired or inherited. It can affect people of all ages. There are various types of cardiomyopathy includes, hypertrophic, dilated, restrictive cardiomyopathy, Arrhythmogenic right ventricular dysplasia and unclassified cardiomyopathy. Some people with cardiomyopathy will never have any signs and symptoms. But in some people the signs and symptoms will develop in the early stages of the disease. As cardiomyopathy worsens and the heart weakens, signs and symptoms of heart failure usually occur. The signs and symptoms of cardiomyopathy includes, shortness of breath or trouble breathing, especially with physical exertion, fatigue, swelling in the ankles, feet, legs, abdomen, and veins in the neck. Other signs and symptoms may include dizziness, light-headedness, fainting during physical activity, irregular heartbeats, chest pain, especially after physical exertion or heavy meals, and heart murmurs. The treatment of cardiomyopathy include lifestyle changes, medicines, surgery, implanted devices to correct arrhythmias (National Heart, Lung, and Blood Institute,

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

The slow descent into madness has long been a pertinent theme in both film and literature. An individual with the semblance of sanity finding themselves wrought by madness as their rational faculty diminishes and actions become sadistic is both fascinating and unsettling. Yet that unnerving element makes it alluring, because madness, as 19th-century romantic writer Edgar Allan Poe has suggested through his works, is inherent in all of us. We’re all a little mad. Poe uses this slow descent into madness as a catalyst in his horror theme prose-tale, “The Tell-Tale Heart” to instill terror.

Written in 1843, The Tell-Tale Heart by Edgar Allan Poe incorporates nearly all of the gothic elements. While this piece of art may not contain all of the gothic elements, it is the epitome of a gothic short story. In The Tell-Tale Heart, the setting seems to be inside an old house, which strengthens the atmosphere of mystery and suspense. The madness and overall insanity of the narrator illustrates the sense of high, overwrought emotion. The presence of creaking hinges and the darkness represent the metonymies of gloom and horror throughout the story.

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

He underwent multiple cardiac related procedures, including a cardiac catheterization and stent placement. After discharge, he developed a fast heart rhythm (180-190 beats per minute -ventricular tachycardia) and other serious heart problems (cardiomegaly, valve regurgitation, and others) that required a cardiac defibrillator implant. He fatigued easily; his condition deteriorated and was hospitalized once more. The diagnoses listed included myocardial infarction (heart attack), acute on chronic respiratory failure, congestive heart failure (CHF), kidney failure, liver failure, hypertension, and anemia. His blood tests were abnormal.

Cardiomegaly also known as Heart muscle disease has many causes from valve infection of the heart, abnormal heart valve to alcohol and cocaine use. The most common causes are coronary heart disease and high blood pressure. Symptoms include shortness of breath, leg swelling and palpitations or skipped heartbeat. Symptoms are more common when the heart has expanded to the point when it is too large and is no longer able to pump blood throughout the body effectively. Some people may never experience any symptoms. That is why it is important to talk to your doctor involving any kind of health concerns. Prevention from this disease include minimal to no drug, tobacco use, having a healthy diet and eating well to reduce the chances of high blood pressure. This is something we all can do as a start. Treatment for cardiomegaly can be medications, medical procedures or surgery. Two forms of Medical treatment are having a small device called a implantable cardioverter-defibrillator or ICD for short; implanted into upper left chest right above the heart. This device monitors heart rhythm and delivers shock when needed when the

Electrocardiographic changes can include left ventricular hypertrophy with repolarisation changes with T wave inversion and deep Q waves. In family members carrying HCM gene mutations, the electrocardiogram may demonstrate only minor abnormalities. The presence of non-sustained ventricular tachycardia, a risk factor for sudden death, should be tested for by means of Holter monitoring (Maron et al., 2003). At present, the diagnosis of HCM relies on echocardiography revealing symmetric or asymmetric hypertrophy. Secondary causes of hypertrophy, including valvular disease or systemic hypertension, should be excluded. 2D imaging of the left ventricle by echocardiography can confirm the diagnosis in affected patients. The ejection fraction, a measure of left ventricular systolic function, is typically preserved but there is usually evidence of diastolic dysfunction. These can be measured by tissue Doppler ultrasonography, which can show diastolic dysfunction before the development of hypertrophy (Maron, 2002). Histologically, HCM is characterized by cardiac myocyte disarray and fibrosis. Myocyte death and myocardial scarring may be present and coronary arteries may have thickened walls. This pathology can promote ventricular tachycardia and ventricular fibrillation (Maron, 2002).

Other forms of secondary restrictive cardiomyopathy include scleroderma, Friedreich’s Ataxia, hemochromatosis, glycogen storage disease and sarcoidosis. Chemotherapy and radiation therapy used to treat cancer can also cause restrictive cardiomyopathy. Sarcoidosis is caused by the infiltration of granulomas in the heart and other tissues of the body. Lungs and lymph nodes are the main organs targeted by this disease, but no organ is spared as it also affects the central nervous system and skin. In the USA, the occurrence in the white population is estimated to be 11 per 100,000. It affects people between the ages of 20 to 30 years and occurs more in women than in men (Dubrey, Bell, Mittal, 2007). Hemochromatosis is caused by the buildup of iron in the heart tissue which can then lead to heart arrhythmias. Scleroderma is a disorder of the connective tissue that leads to fibrosis of the skin, heart and lungs. Glycogen storage disease, also named Pompe’s affects infants. It causes increased storage of glycogen and fat tissue in the body. This causes the heart then to become very heavy and thick. Infants tend to struggle to breath, have trouble feeding and fail to meet developmental steps on time like rolling over and sitting up.

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

Takotsubo cardiomyopathy also called as Stress-induced transient cardiomyopathy, apical ballooning syndrome, and broken heart syndrome was first reported in 1991 [1 in Japan, and accounts for 1.2% of acute coronary syndromes (ACS) that present with elevated cardiac biomarkers [1,2,3. The condition is often associated with acute medical illnesses, catastrophic life events, and intense physical or emotional stress [2, 3. Although the pathogenesis of stress-induced cardiomyopathy is not fully understood, the hypothesis includes catecholamine excess [16, coronary vasospasm, micro vascular dysfunction and dynamic mid cavity or left ventricular outflow tract obstruction. Postmenopausal women appear to be at a higher risk for developing the disease as about 80% of Takotsubo cardiomyopathy occurs in postmenopausal women [3].