CARDIOMYOPATHY

MIKE KIWA
BSCN/KRCHN
OBJECTIVES
• By the end of this session, you will be able to;
a) Define cardiomyopathy
b) State the types of cardiomyopathy
c) Discuss causes of cardiomyopathy
d) Describe the pathophysiology of
cardiomyopathy
e) State the signs and symptoms of
cardiomyopathy
Cont…
• Discuss the diagnostic tests
• Explain the management of a patient with
cardiomyopathy
• Nursing management
• Medical management
• Discuss complications associated with
cardiomyopathy
Definition
• A condition of the cardiac muscle
• Myocardium weakens and stretches
• The heart loses its pumping strength
• It also becomes enlarged
Cont…
• The heart functions remain
• However, contractions are weak
• The result is decreased cardiac output
Types; a) Dilated Cardiomyopathy
• The heart muscle thins, enlarges
• Hypertrophy and dilatation result
• Affects pumping action of ventricles
• Leads to congestive heart failure.
Pic
Pics
b) Hypertrophic cardiomyopathy
• The ventricular heart muscle thickens
• Blood flow and pumping are impaired
Pic
c) Restrictive cardiomyopathy
• The heart muscle becomes stiff
• Restricts blood from filling ventricles
• Myocardium loses elasticity
• Build up of scar tissue
Pic
Pathophysiology
• The heart muscle becomes enlarged
• It is thick or rigid
• Myocardium is replaced with scar tissue.
• The heart becomes weak
Cont…
• Less able to pump blood
• Incapable of maintaining normal electrical
rhythm
• The result can be heart failure
• Risk of thrombi formation
Causes
• Heredity
• Hypertension
• Open-heart surgery; myocardial fibrosis
• Toxins
Cont…
• Amyloidosis; abnormal protein in tissues
Clinical manifestations
• Dyspnea—increase pressure in the lungs.
• Angina—due to oxygen demand
• Syncope—Fainting attacks
• Abnormal heart sounds; abnormal blood flow
Cont…
• Shortness of breath
• Fatigue
• Tachycardia
• Dizziness
Diagnostic tests
• Chest x-ray (CXR); enlarged heart
• Echocardiography; left ventricular hypertrophy
• Electrocardiogram: ST changes
• Vital signs;
Management
Medical management ;
• Beta adrenergic blockers—slows heartbeat
• ACE inhibitors—decrease left ventricular filling
• Calcium channel blockers—increase cardiac
contractility
Cont…
• Anticoagulant; reduce the coagulation of
blood
• Diuretics reduce fluid retention
Surgical management
• Myectomy;
• Incision into septum
• Removal of tissue.
Nursing management
• Place patient in a semi-Fowler’s position
• Record intake and output of fluids
• Monitor vital signs
Cont…
• Monitor electrocardiogram
• Fluids restriction
• Record daily weight
• Lifestyle adjustments
Complications
• Heart failure
• Pulmonary embolism
Assignment
• In not more than 500 words formulate nursing
diagnoses for a patient with cardiomypathy

Deadline 27/01/2020
References
• Turgeon, M. L. 2010. Clinical hematology;
Theory and Procedures. 5th ed. Lippincott
Williams and Wilkins
• Hinkle, J. L., Cheever, K. H. 2013. Brunner and
Suddarth’s Textbook of Medical-Surgical
Nursing. 13th ed. Lippincott Williams and
Wilkins