Pathophysiology Of Dilated Cardiomyopathy

High Blood Pressure Exercise Program

Alternative Medicine for Hypertension Found

Get Instant Access

Dilated cardiomyopathy refers to intrinsic myocardial disease. The etiology is often idiopathic, while in others it may be related to definable etiological factors such as ethanol-related myocardial damage or a definite viral myocarditis. Whatever may be the etiology, the hallmark of the disorder is a dilated poorly contracting left ventricle, and

Table 6 Hypertension

Pathophysiological changes Clinical symptoms/signs

Table 6 Hypertension

Pathophysiological changes Clinical symptoms/signs

& Asymptomatic for long time

Increased systolic LV wall tension

& Atypical chest pain

Increased O2 demand

& Angina

Increased LV filling pressure

& Dyspnea

Decreased subendocardial flow

& Palpitation

Increased left atrial pressure

Decreased LV compliance

& S4/atrial kick

Severe hypertension or decreased LV systolic function

& Sustained LV apex

Subendocardial ischemia ± fibrosis

& ECG—repolarization abnormalities

& LVH strain pattern

LV, left ventricular; ECG, electrocardiogram; LVH, left ventricular hypertrophy.

LV, left ventricular; ECG, electrocardiogram; LVH, left ventricular hypertrophy.

Cardiomyopathy Pathophysiology
Fig. 9.

the process might involve equally the right ventricle. The increased radius caused by the dilatation would increase the oxygen demand by raising the left ventricular wall tension both during systole and diastole. The diastolic dysfunction would contribute to decreased left ventricular compliance. Other factors that may be involved in the decrease of the ventricular compliance include myocardial fibrosis in longstanding cases. The decreased compliance will lead to increased filling pressures in the ventricle. This would account for both systemic and pulmonary congestion. In addition, it will contribute to decreased subendocardial capillary flow. That will further cause abnormal rise in the filling pressures (Fig. 9).

Table 7

Dilated Cardiomyopathy

Table 7

Dilated Cardiomyopathy

Pathophysiological changes

Clinical symptoms/signs

• Increased radius

ß

Displaced large-area LV apex

• Increased duration of systolic tension

ß

Sustained LV apex

• Reduced ejection fraction

• Increased LV/RV filling pressures

ß

Dyspnea/edema

• Decreased stroke volume

ß

Low-volume (amplitude) pulse

ß

Low-output symptoms

• Severe reduction in ejection fraction

ß

Poorly felt apex beat

LV, left ventricular; RV, right ventricular.

LV, left ventricular; RV, right ventricular.

Clinical Symptoms and Signs in Dilated Cardiomyopathy

The increased radius will cause a large-area displaced left ventricular apical impulse. If the contractility is significantly reduced, then the accompanying decreased ejection fraction will give rise to a sustained apical impulse. The increased left and right ventricular filling pressures will lead to pulmonary and systemic congestion, causing symptoms of dyspnea and peripheral edema. When the ejection fraction is significantly reduced, the stroke volume may be low and give rise to low-amplitude low-volume pulse. Severe decrease in ejection fraction and stroke volume may actually lead to a very poorly felt apical impulse (Table 7) (51,52).

Was this article helpful?

+1 0
Reducing Blood Pressure Naturally

Reducing Blood Pressure Naturally

Do You Suffer From High Blood Pressure? Do You Feel Like This Silent Killer Might Be Stalking You? Have you been diagnosed or pre-hypertension and hypertension? Then JOIN THE CROWD Nearly 1 in 3 adults in the United States suffer from High Blood Pressure and only 1 in 3 adults are actually aware that they have it.

Get My Free Ebook


Post a comment