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2.1
Left Ventricular Dilatation

Presentation

Presents 70 fully illustrated case presentations with teaching points that make information easy to understand and digest. [books.google.com]

A 58-year-old woman with a previous anterior myocardial infarction, recurrent chest pain, transient adenosine-induced left ventricular dilatation but no apparent epicardial disease on angiography is presented. [ncbi.nlm.nih.gov]

Cardiovascular

  • Heart Disease

    ICD-10-CM Codes › I00-I99 Diseases of the circulatory system › I30-I52 Other forms of heart disease › I51- Complications and ill-defined descriptions of heart disease › Cardiomegaly 2016 2017 2018 2019 Billable/Specific Code I51.7 is a billable/specific [icd10data.com]

    Abstract Coronary heart disease and beta-blocker treatment can increase the use of the Frank-Starling mechanism during exercise. The aim of the study was to assess whether this could be influenced by physical training. [ncbi.nlm.nih.gov]

    […] artery disease or heart attack cause the disease. [heart.org]

    Atrial fibrillation is a common manifestation of hypertensive heart disease. Hypertensive heart disease is the leading identifiable cause of heart failure in older women. [clevelandclinicmeded.com]

  • Cardiomegaly

    2012 ICD-9-CM Diagnosis Code 429.3 Cardiomegaly ICD-9-CM 429.3 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 429.3 should only be used for claims with a date of service on or before September 30 [icd9data.com]

    Cardiomegaly is a nonspecific symptom seen in patients with chronic systolic heart failure (heart failure) or several forms of cardiomyopathies. Hypertrophy or enlargement of the heart. [icd10data.com]

    DIAGNOSTIC STUDIES ( Table 7 ) The chest x-ray may demonstrate cardiomegaly, pulmonary congestion and sometimes pleural effusion. Laboratory tests Routine tests should include CBC, electrolytes, BUN, creatinine, urinalysis. [brown.edu]

    Cardiomegaly on chest x-ray: prognostic implications from a ten-year cohort study of elderly subjects: a report from the Bronx Longitudinal Aging Study. Am Heart J 1992 ;124: 1026 - 1030 3. Lauer MS, Evans JC, Levy D. [nejm.org]

    Cardiomegaly persisting longer than 4-6 months carries a mortality of 50% at 6 years. Subsequent pregnancies in women with cardiomyopathy carries a substantial risk of clinical deterioration, particularly in those who did not recover LV function. [emedicine.medscape.com]

  • Gallop Rhythm

    Examination should focus on whether the heart is palpably dilated, the presence of murmurs, and additional heart sounds (gallops). [clevelandclinicmeded.com]

Workup

Axis

  • Left Axis Deviation

    Common ECG associations with DCM Left atrial enlargement -> may progress to atrial fibrillation. Biatrial enlargement Left ventricular hypertrophy or biventricular enlargement Left bundle branch block ( RBBB can also occur). Left axis deviation. [lifeinthefastlane.com]

P Wave

  • P Mitrale

    - signs of pulmonary congestion. 2.ECG: - P mitral. - LV dilatation. 3.Echocardiography: - determine degree of regurge. - LV dimensions. - EF 25 Complications: LV failure. Pulmonary hypertension. AF. Thrombus formation. Rheumatic activity. [slideplayer.com]

Treatment

Depending on infarct size and ventricular function, continued treatment in the chronic phase of heart failure must be considered. [ncbi.nlm.nih.gov]

EGDS is a relatively simple technique with good results and the absence of postoperative encephalopathy, and it is the treatment of choice for the majority of groups undergoing treatment of schistosomiasis presinusoidal portal hypertension [ 5, 9, 10 [journals.plos.org]

Prognosis

This classification identifies subgroups differing with regard to systemic haemodynamics, left ventricular function and cardiovascular prognosis. [ncbi.nlm.nih.gov]

A detailed analysis demonstrated an association between prognosis and amount of LGE in combination with impaired left ventricular ejection fraction. [wikiecho.org]

Etiology

Regardless of etiology, cardiac enlargement is associated with decreased survival. Cardiac enlargement after acute myocardial infarction (AMI) may be a progressive process. [karger.com]

Several other mechanisms apply also to dilative types of heart failure of various, non-ischemic etiologies. We hypothesized that hyperhomocysteinemia is associated with left ventricular (LV) dilatation and hypertrophy in dilative cardiomyopathy. [ncbi.nlm.nih.gov]

DILATED CARDIOMYOPATHY ETIOLOGY ( Table 3 ) Although most cases of dilated cardiomyopathy are idiopathic, several etiologies have been implicated in the pathogenesis of dilated cardiomyopathy. [brown.edu]

Etiology Although a variety of etiologies can result in a dilated cardiomyopathy which are listed as below. Some are classified as separate entities. [radiopaedia.org]

Epidemiology

الصفحة 129 - Epidemiologic aspects of infective endocarditis in an urban population. A 5-year prospective study. Medicine. ‏ [books.google.com]

The Framingham Study: an epidemiological investigation of cardiovascular disease. Section 34. [nejm.org]

Epidemiological and economic burden of metabolic syndrome and its consequences in patients with hypertension in Germany, Spain and Italy; a prevalence-based model. BMC Public Health 2010; 10 : 529. 3. [nature.com]

[…] corticosteroids; thus, timely diagnosis via EMB is prudent. [13, 14] Treatment with cyclosporine and corticosteroids is associated with a median transplant-free survival of 12.3 months compared to 3 months without immunosuppression. [15] The European Study of Epidemiology [emedicine.medscape.com]

Pathophysiology

These findings extend previous reports and provide a pathophysiological rationale for the observed unfavourable prognosis in patients with left ventricular dilatation. [ncbi.nlm.nih.gov]

PATHOPHYSIOLOGY ( Table 4A, Table 4B ) In the early stages, compensatory mechanisms (i.e. neurohormonal) help to maintain cardiac output. [brown.edu]

The idiopathic category should continue to diminish as more information explaining pathophysiologic mechanisms, specifically genetic-environmental interactions, becomes available. Toxins are a significant cause. [emedicine.medscape.com]

Pathophysiology Dilated cardiomyopathy represents the final common morphologic outcome of various biologic insults. The combination of myocyte injury and necrosis associated with myocardial fibrosis results in impaired mechanical function. [clevelandclinicmeded.com]

Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation. 2008 Apr 1;117(13):1717-31. [escardio.org]

Prevention

This edition has new chapters on impact and treatment of comorbidities, prevention of sudden cardiac death, rationale for use of anticoagulants, ultrafiltration, use of mechanical devices, and gene and cell therapy. [books.google.com]

Neurohormonal blockade in patients with acute MI is shown to prevent adverse remodeling, prevent HF, and prolong survival. A reduction in wall stress during MI has been proposed to reduce infarct expansion and acute dilation. [acc.org]

The primary goal is to improve cardiac function and prevent symptoms. Individuals with DCM need to be followed by a cardiologist on a regular basis. [cincinnatichildrens.org]

His research aims to find better ways to diagnose, treat and prevent people dying from this disease, and beat the heartbreak. Donate [bhf.org.uk]

In some cases, this prevents the heart from filling with blood as it should. Over time, it can affect the other chambers. Symptoms Many people with dilated cardiomyopathy have no symptoms. Some that do have only minor ones, and live a normal life. [webmd.com]

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