Cardiomyopathy

Description:

The cardiomyopathy is a change of a muscle of heart of often obscure reason. "Cardiomyopathy" is a diagnosis condition absence (or an exception after inspection) congenital anomalies of development, valve heart diseases, the defeat caused by general diseases of vessels, an arterial hypertension, a pericardis, and also some rare options of defeat of the carrying-out system of heart.

Cardiomyopathy symptoms:

Disturbance of sokratitelny function of a cardiac muscle (myocardium) with the expressed expansion of cameras of heart is characteristic of a dilatatsionny cardiomyopathy. Emergence of a dilatatsionny cardiomyopathy is connected with genetic factors as the family nature of a disease meets. Also observed disturbances of immune regulation have not smaller value.
Manifestations of a dilatatsionny cardiomyopathy are defined by the accruing heart failure (an asthma at an exercise stress, bystry fatigue, hypostases standing, pallor of skin, a posineniye of finger-tips).

The forecast at a dilatatsionny cardiomyopathy is very serious. Accession of atrial fibrillation worsens the forecast. In the first 5 years of a disease about 70% of patients though at regular, controlled medicinal therapy, undoubtedly, it is possible to achieve extension of life of the patient die. Women with a dilatatsionny cardiomyopathy should avoid pregnancy as the frequency of maternal mortality at this diagnosis is very high. Provocative influence of pregnancy on development of a disease is in certain cases noted.

Hypertrophic cardiomyopathy - the disease which is characterized by significant increase in thickness of a wall of a left ventricle without expansion of a cavity of ventricles. The hypertrophic cardiomyopathy can be both inborn, and acquired. Genetic defects are a probable cause of a disease.

Manifestations of a hypertrophic cardiomyopathy is defined by complaints to an asthma, pains in a thorax, tendency to faints, heartbeat. Owing to disturbances of a rhythm patients with a hypertrophic cardiomyopathy often die suddenly. The hypertrophic cardiomyopathy quite often is found in the young men who died during sports activities. At a part of patients heart failure gradually develops; sometimes, especially at elderly, the circulatory unefficiency develops suddenly after long favorable disease for many years.

As a result of disturbance of relaxation of a left ventricle the picture of heart failure is observed though contractility of a left ventricle remains on normal indicators up to the beginning of an end-stage of a disease.

Decrease in distensibility of cameras of heart is a blood circulation cause of infringement at a hypertrophic cardiomyopathy (first of all a left ventricle). The left ventricle changes the form that is defined by preferential localization of the site of a thickening of a myocardium. The thickening of a partition leads to increase in pressure while the taking-out path extends, its walls become thinner.

The restrictive cardiomyopathy is the disease of a myocardium which is characterized by the disturbance of sokratitelny function of a cardiac muscle lowered by relaxation of its walls. The myocardium becomes rigid, walls do not stretch, filling suffers from blood of a left ventricle. The thickening of a ventricle or its expansion at the same time is not observed, unlike the auricles experiencing the raised strain.

The restrictive cardiomyopathy - the most rare form of cardiomyopathies, it exists both in independent option, and at damage of heart at rather big circle of diseases which have to be excluded during specification of the diagnosis. It is an amyloidosis, hemochromatosis, a sarcoidosis, endomyocardial fibrosis, Lyoffler's disease, a fibroelastosis, sometimes defeats of the carrying-out system of heart (Fabri's disease). Damages of heart owing to disturbances of exchange of a glycogen occur at children.

Cardiomyopathy reasons:

Allocate three main types of damage of a muscle of heart at cardiomyopathies, respectively, the dilatatsionny cardiomyopathy, a hypertrophic cardiomyopathy and a restrictive cardiomyopathy is allocated. Such division usually is based on assessment of an endocardiac krovoorashcheniye and already at an initial stage of a disease allows to establish in some cases napravlenitleiye search of the possible reason of process. At the unspecified prime cause of defeat speak about idiopathic forms of this or that cardiomyopathy.

Treatment of the Cardiomyopathy:

Treatment of a dilatatsionny cardiomyopathy is directed to fight against heart failure, prevention of complications. The main efforts to therapies go to a lowering of arterial pressure by means of APF inhibitors. It is possible to use any of drugs of this group, but is wider than others now enalapril is used (ренитек). The dosage is always individual and fluctuates from 2,5 to 40 mg a day, in one or two receptions. Captopril in doses of 6,5-25 mg demands triple reception. The choice of specific drug is defined by portability, reaction of arterial pressure, side effects. The important place is taken by use of small doses of beta-blockers. Treatment begin with the minimum doses of drug, for example a metoprolol of 12,5 mg twice a day. In case of good tolerance the dose can be increased, observing whether symptoms of heart failure accrue. Drug use карведилол - the beta alpha blocker having positive antioxidant influence on a myocardium, unique for this group, is perspective.

As well as at treatment of the heart failure caused by other diseases, use of diuretic is of traditionally great importance. Their effect is traced by control of weight of the patient (it is desirable several times a week or daily), measurement of volume of an urination, observation of electrolytic composition of blood.

Because of the bad forecast of a disease patients with a dilatatsionny cardiomyopathy are considered by candidates for performing transplantation of heart.

Treatment of a hypertrophic cardiomyopathy is directed first of all to improvement of sokratitelny function of a left ventricle. Verapamil in doses from 240 mg a day or diltiazem is most often used (120 mg a day and above). Beta-blockers which promote heartbeat reduction are widely used, interfere with emergence of disturbances of a rhythm. Use of Disopyramidum is recommended.

For treatment of a hypertrophic cardiomyopathy use of a pacemaker for two-chamber constant electrocardiostimulation is recommended in recent years.

Treatment of a restrictive cardiomyopathy is represented a complex challenge because of late negotiability of patients, difficulty of diagnosis, lack of reliable methods of a stop of process. Heart transplantation can be inefficient because of a process recurrence in transplantirovanny heart. At the established secondary nature of defeat there are specific ways of influence, for example bloodletting at hemochromatosis, corticosteroids at a sarcoidosis.