Cardiomyopathy

(Cardiac Muscle
Dysfunction)

Dr. Muhammad Iqbal Tariq
DPT, Ms-CPPT, PGD(T&M)
Cardio-Pulmonary Rehab Specialist
Senior Lecturer
Riphah International University
 Cardiomyopathy

 Cardiomyopathy is a group of diseases that affect the heart
muscle.

 Early on there may be few or no symptoms.

 Some people may have shortness of breath, feel tired, or have 

swelling of the legs due to heart failure.

 An irregular heart beat may occur as well as fainting.

 Those affected are at an increased risk of sudden cardiac death.

 FIGURE: Left ventricle showing thickening, dilatation, and
subendocardial fibrosis noticeable as increased whiteness of the 
inside of the heart.


 Types of
cardiomyopathy

 Hypertrophic Cardiomyopathy
 Dilated Cardiomyopathy
  Restrictive Cardiomyopathy
 Arrhythmogenic Right Ventricular Dysplasia
 Takotsubo Cardiomyopathy (Broken Heart
Syndrome)

 Hypertrophic
cardiomyopathy

 Hypertrophic cardiomyopathy (HCM) is a condition
in which a portion of the heart becomes thickened
without an obvious cause. This results in the heart
being less able to pump blood effectively.

 Symptoms vary from none to feeling tired, leg swelling,

and shortness of breath.
 It may also result in chest pain or fainting
 Complications include heart failure, an 
irregular heartbeat, and sudden cardiac death.

Dilated cardiomyopathy

 Dilated cardiomyopathy (DCM) is a condition in which
the heart becomes enlarged and cannot pump blood
 effectively.
 Symptoms vary from none to feeling tired, leg swelling,
and shortness of breath.

 It may also result in chest pain or fainting

 Complications can include heart failure, 

heart valve disease, or an irregular heartbeat

 
 Causes include genetics, alcohol, cocaine, certain toxins,
complications of pregnancy, and certain infections.

 Coronary artery disease and high blood pressure

 may play a role, but are not the primary cause

 In many cases the cause remains unclear.[6]It is a type

of cardiomyopathy, a group of diseases that
primarily affects the heart muscle
 Restrictive
cardiomyopathy

 Restrictive cardiomyopathy (RCM) is a form of 
cardiomyopathy in which the walls of the heart are
rigid (but not thickened).
 Thus the heart is restricted from stretching and
filling with blood properly.
 It is the least common of the three original subtypes
of cardiomyopathy: hypertrophic, dilated, and
restrictive.
 Arrhythmogenic right
ventricular dysplasia (ARVD)

 It is an inherited heart disease.
 ARVD is caused by genetic defects of the parts of 
heart muscle (also called myocardium or cardiac
muscle) known as desmosomes, areas on the surface
of heart muscle cells which link the cells together.
The desmosomes are composed of several proteins,
and many of those proteins can have harmful 
mutations.
 
 The disease is a type of nonischemic cardiomyopathy that
involves primarily the right ventricle. It is characterized
by hypokineticareas involving the free wall of the right
ventricle, with fibrofatty replacement of the right
ventricular myocardium, with associated arrhythmias
 originating in the right ventricle.
 Up to 80% of individuals with ARVD present have
symptoms like syncope and dyspnea. Symptoms are
usually exercise-related.
 The first clinical signs of ARVD are usually during 
adolescence. 
 Takotsubo
cardiomyopathy

 Takotsubo cardiomyopathy, also known as stress
cardiomyopathy, is a type of non-ischemic 
cardiomyopathy in which there is a sudden temporary
weakening of the muscular portion of the heart.
 This weakening may be triggered by emotional stress, such
as the death of a loved one, a break-up, rejection from a
partner or constant anxiety. This leads to one of the
common names, broken heart syndrome.
 Stress cardiomyopathy is now a well-recognized cause of
acute heart failure, lethal ventricular arrhythmias, and 
ventricular rupture
 
 The name "takotsubo syndrome" comes from the
Japanese word takotsubo (ja) "octopus trap," because
the left ventricle takes on a shape resembling a 
fishing pot

 
 The typical presentation of takotsubo cardiomyopathy is
a sudden onset of chest pain associated with ECG changes
mimicking a myocardial infarction of the anterior wall.
 During the course of evaluation of the patient, a bulging
out of the left ventricular apex with a hypercontractile
base of the left ventricle is often noted.
 It is the hallmark bulging-out of the apex of the heart with
preserved function of the base that earned the syndrome
its name takotsubo (ja) "octopus trap," in Japan, where it
was first described.