Diseases of the heart muscle Cardiomyopathy Diseases of the heart muscle

Lots of different types and terms Enlarged, thinned walled and ‘baggy’ Thickened walls Rigid/stiff walls Combination Inherited Acquired

Heart muscle’s ability to act as a pump (the engine of the body) becomes poor >>>>>heart failure

Heart failure Effort intolerance Breathless Chest pain Fatigue Leg and /or abdominal swelling Symptoms of congestion- ‘congestive cardiac failure’

Can lead to rhythm disturbance ( electrical problems) Can lead to heart valve problems Can affect any age, but becomes more common as you get older

Dilated Cardiomyopathy Big, baggy heart- ‘low EF%’ - Ischaemic (Coronary artery disease ( plumbing)) -Burnt out hypertension - Familial /inherited - Alcohol cardiomyopathy - Post viral (myocarditis) - Unknown (idiopathic) - Pregnancy related (peripartum) - due to rhythm disturbance (tachycardia mediated) - due to severe heart valve problem - due to chemotherapy or radiotherapy - dysynchrony

OMT- Optimal medical therapy ACE I/ ARB BB MRA Water tablets

Disease specific treatment Revascularization- controversial Valve surgery Reduce alcohol Control heart rhythm problem More later with stiff and thick hearts!

Hypertrophic cardiomyoathy Thickened heart wall- very thick to very minor thickening- often asymmetric Abnormal ECG Inherited, but can ‘pretend’ to skip generations 1:500 High blood pressure can ‘mimic’ Lots of other rare mimics

Stiff hearts High blood pressure Type II diabetes Amyloid Haemochromatosis Sarcoidosis Idiopathic restrictive cardiomyopathy Radiotherapy

Right sided heart failure As a consequence to left sided heart failure As a consequence to chronic lung disease- Cor Pulmonale ARVC- arrhythmogenic right ventricular dysplasia Non –compaction Takotsubo cardiomyopathy- broken heart syndrome

Prevention/ risk factors Family history Coronary disease- lipids/smoking/ Blood pressure Diabetes Obesity Alcohol Exercise

Treatment Family history Coronary disease- lipids/smoking/ Blood pressure Diabetes Obesity Alcohol Exercise

Optimal medical therapy Disease specific therapy Cardiac surgery Device therapy Transplant