Presentation
We present a challenging case of a young man presenting with ischemic-looking electrocardiogram (ECG) changes, fever, hypotension, and global left ventricular hypokinesis. [radcliffecardiology.com]
Presentation symptomatology can be nausea, dizziness, anxiety, dyspnea and palpitations. [bmcresnotes.biomedcentral.com]
Aneurysmal subarachnoid hemorrhage may induce Takotsubo cardiomyopathy that can present as an acute ST-elevation myocardial infarction. [link.springer.com]
10.1016/S1885-5857(09)73549-2 Baltasar Laínez a, Marina Ureña a, Virginia Álvarez a, Román Lezaun a a Servicio de Cardiología, Hospital de Navarra, Pamplona, Navarra, Spain Article To the Editor, Tako-Tsubo cardiomyopathy (TC) is a syndrome of clinical presentation [revespcardiol.org]
A53-year-old woman presented with progressive dyspnea. Family history was positive for Fabry’s disease. Cardiac MRI showed marked thickening of the left ventricle (Figure 1, arrow). [circ.ahajournals.org]
Entire Body System
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Congestive Heart Failure
heart failure. hypertrophic cardiomyopathy an increase in heart muscle weight, particularly of the left ventricle and often involving the interventricular septum; it may affect the flow of blood from an atrium into the ventricle or out from the ventricle [medical-dictionary.thefreedictionary.com]
Congestive heart failure in rickets caused by vitamin D deficiency. Monatsschr Kinderheilkd 1989 ; 137 : 108 – 110. 8. Kim, BG, Chang, SK, Kim, SM, Hwang, JS, Jung, JW. [cambridge.org]
Pulmonary team was consulted; the impression was consistent with pulmonary edema from questionable congestive heart failure (CHF), which could have been from the history of cocaine use rather than a primary pulmonary cause. [bmcresnotes.biomedcentral.com]
Congestive Heart Failure This is a common feature of all late stage cardiomyopathies when the muscles of the heart become too weak to pump enough blood to the body for normal function. [childrenscardiomyopathy.org]
heart failure (chf) with cardiomyopathy Congestive heart failure due to cardiomyopathy Primary cardiomyopathy Secondary cardiomyopathy Tachycardia induced cardiomyopathy Clinical Information A disease of the heart muscle or myocardium proper. [icd10data.com]
Respiratoric
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Sputum
His other complaints included productive cough with whitish blood-tinged sputum, frontal headache, mild subjective fever and mid-sternal chest discomfort. Past medical history included only hypertension. No home medications were used. [bmcresnotes.biomedcentral.com]
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Agonal Respiration
Paramedics were called and found her unresponsive with agonal respirations. [link.springer.com]
Cardiovascular
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Heart Disease
disease, and various chemicals and drugs. [medical-dictionary.thefreedictionary.com]
No patients had hypertension, drug or alcohol abuse, ischemic heart disease or systemic disorders. [onlinejacc.org]
Understand Your Risk for Cardiomyopathy Symptoms and Diagnosis of Cardiomyopathy Prevention and Treatment of Cardiomyopathy Cardiomyopathy in Children Learn more: Family History and Heart Disease Alcohol and Heart Disease Cocaine, Marijuana and Other [heart.org]
Therefore, code 425.8 should be added to 414.8 (other specified forms of chronic ischemic heart disease) for ischemic cardiomyopathy. But it's ischemic heart disease. Wait a second. [hcpro.com]
Epidemiology In contrast to coronary heart disease having a higher incidence in the elderly, cardiomyopathies can occur at younger ages. [patient.info]
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Tachycardia
Dose-dependent tachycardia, hypertension along with increased arousal is the first physiological response to cocaine use. [bmcresnotes.biomedcentral.com]
The patient’s heart rate increased to 130bpm immediately after the intubation, with telemetry showing sinus tachycardia. An ECG was performed within one minute after intubation (see Figure 1 ). [radcliffecardiology.com]
Although the number of patients studied may not be representative, the incidence of ventricular tachycardia seems to be associated with higher values of TE (Table 1). [onlinejacc.org]
Tachycardia-induced cardiomyopathy Persistently high heart rates (above 110 beats per minute), such as in sustained ventricular tachycardia, or associated with atrial fibrillation, results in heart failure when left untreated. [textbookofcardiology.org]
With prolonged arrhythmias, the heartbeat may become either too fast (tachycardia) or too slow (bradycardia) and can occur in either the heart ventricles or atrial. [childrenscardiomyopathy.org]
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Cardiomegaly
Cardiomegaly is usually considered a requisite for the diagnosis of dilated cardiomyopathy. [8] The mean heart weight is about 600 g. [9] Some patients with dilated cardiomyopathy have very little cardiac enlargement, and the diagnosis must be made on [emedicine.medscape.com]
Cardiomegaly may be suspected on chest radiography, and the electrocardiogram shows non-specific abnormalities of the ST-segment and T-waves. Conduction defects may also occur. [textbookofcardiology.org]
Common abnormalities seen on the chest radiograph include cardiomegaly, interstitial edema, pleural effusion(s), and evidence of previous sternotomy (sternal wires). [clevelandclinicmeded.com]
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Gallop Rhythm
rhythm, persistent jugular venous distention, systemic hypotension, peripheral vascular disease Laboratory findings Hyponatremia, persistently elevated B-type natriuretic peptide and A-type natriuretic peptide levels, elevated norepinephrine and renin [clevelandclinicmeded.com]
An important feature of the physical examination is a gallop rhythm of S3 and S4. S3 and S4 may fuse in tachycardic patients with new onset of heart failure. [textbookofcardiology.org]
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Heart Murmur
Evaluate for heart murmur. Evaluate for femoral pulses. Evaluate for physical features suggestive of Marfan syndrome. Obtain blood pressure. [aafp.org]
Musculoskeletal
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Muscle Spasticity
Citation American Heart Hospital Journal 2010;8(1):52-4 DOI Baclofen intrathecal infusion is frequently used to treat muscle spasticity of spinal or cerebral origin. [radcliffecardiology.com]
Neurologic
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Akinesia
Images from transthoracic ECG and ventriculography within first hours of exhibiting the symptoms showing extensive akinesia with preserved contraction in more basal portions (B and D). [revespcardiol.org]
[…] ejection fraction 40% By RV angiography: Regional RV akinesia, dyskinesia, or aneurysm Minor By 2D echo: Regional RV akinesia or dyskinesia and 1 of the following (end diastole): PLAX RVOT 29 to 2 ) PSAX RVOT 32 to 2 ) or fractional area change 33% to [textbookofcardiology.org]
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Quadriplegia
Case Report A 23-year-old man with a history of quadriplegia and muscular spasticity secondary to a previous motor vehicle accident presented to the emergency department for refill of his baclofen pump. [radcliffecardiology.com]
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Intracranial Hemorrhage
Keywords Takotsubo Cardiomyopathy Apical ballooning syndrome Subarachnoid hemorrhage Intracranial hemorrhage ECG abnormalities Background Aneurysmal subarachnoid hemorrhage (SAH) has a reported mortality of 30 to 50%. [link.springer.com]
Workup
Initial laboratory workup at admission was insignificant except for elevated brain nautriuretic peptide of 894 ng/L and positive urine toxicology screen for cocaine. [bmcresnotes.biomedcentral.com]
The term "idiopathic" means that the physician cannot determine the cause of the cardiomyopathy despite extensive workup. If the physician can determine the cause, then by definition it's secondary cardiomyopathy. [hcpro.com]
Blocks
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Incomplete Right Bundle Branch Block
A previous ECG (two years ago) showed incomplete right bundle branch block morphology but no other abnormality. [radcliffecardiology.com]
T Wave
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T Wave Inversion
These may include electrocardiogram (ECG) changes of QT prolongation and T wave inversion, elevated biochemical markers of myocardial damage and heart failure, and decreased left ventricular function [ 1 ]-[ 3 ]. [link.springer.com]
Electrocardiographic diagnostic criteria for HCM in first-degree relatives of index cases with HCM : Major: Left ventricular hypertrophy and repolarization changes T-wave inversion in leads I and aVL ( 3mm) (with QRS–T wave axis difference 30 ), V3–V6 [textbookofcardiology.org]
Hypertrophy
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Left Ventricular Hypertrophy
Electrocardiogram on admission showed sinus tachycardia; left atrial enlargement, left ventricular hypertrophy and nonspecific T wave abnormalities over the anterior wall leads. [bmcresnotes.biomedcentral.com]
Beware of encoders What about a patient with left ventricular hypertrophy due to increased work caused by aortic stenosis? Physicians refer to this as valvular heart disease. In their minds, it's a cardiomyopathy. [hcpro.com]
Cardiac involvement is characterized by left ventricular hypertrophy, electrographically and echocardiographically, but cardiac symptoms are frequently absent. [textbookofcardiology.org]
Important complications of fibrosis include left ventricular hypertrophy, as well as systolic and diastolic dysfunction of both ventricles. [reumatologiaclinica.org]
Treatment
Non-invasive testing should be performed after several months to re-evaluate the treatment response. [bmcresnotes.biomedcentral.com]
Khorasani A, Peruzzi WT, Dantrolene treatment for abrupt intrathecal baclofen withdrawal, Aneth Analg, 1995;80:1054–6. [radcliffecardiology.com]
Physicians need to be aware of this possibility since it can lead to significant delays and treatment options for the patient. [link.springer.com]
Some people will not need any treatment. Treatment of secondary cardiomyopathy may involve treating the underlying condition. [mydr.com.au]
Each infant required IV calcium for up to 5 days with subsequent oral calcium treatment. They were all treated with oral vitamin D for between 6 and 12 months. [imj.ie]
Prognosis
These patients had a poor short term prognosis (p 0.001). [ncbi.nlm.nih.gov]
Apical and mid-ventricular transient left ventricular dysfunction syndrome (Tako-tsubo cardiomyopathy): frequency, mechanisms, and prognosis. Chest. 2007;132: 809-16. Medline 5. [revespcardiol.org]
[…] indicated in patients with LVEF The prognosis of LVNC has currently not yet been defined. [textbookofcardiology.org]
Given the patient's poor prognosis when she arrived, it is unclear if the heparin she received during cardiac catheterization worsened her SAH or changed her outcome. [link.springer.com]
Identification of these areas and restoration of their perfusion through revascularization might improve the ejection fraction and long-term prognosis. [clevelandclinicmeded.com]
Etiology
[…] of abnormal substances, as may occur in amyloidosis, hemochromatosis, and other disorders. primary cardiomyopathy that in which the basic pathologic process involves the myocardium itself and not other cardiac structures; the condition is of unknown etiology [medical-dictionary.thefreedictionary.com]
Cardiomyopathies may be classified as either primary or secondary, on the basis of etiology, or on the pathophysiology of the lesion: hypertrophic, dilated, or restrictive. [icd10data.com]
Cardiomyopathies may be classified as either primary or secondary, on the basis of etiology, or on the pathophysiology of the lesion: hypertrophic, dilated, or restrictive. [ NCIT : C34830 ] Synonyms: extrinsic cardiomyopathy, [X]Cardiomyopathy in other [ebi.ac.uk]
These mechanisms may be responsible for the etiology for the TCM that occurred in our patient. TCM most commonly occurs in women (89%) with a mean age of 68. Forty-six percent of cases are triggered by intense emotional or physical stress. [link.springer.com]
Etiology The causes of cardiomyopathies are varied ( Table 2 ). 1 Dilated cardiomyopathy in adults is most commonly caused by CAD (ischemic cardiomyopathy) and hypertension, although viral myocarditis, valvular disease, and genetic predisposition may [aafp.org]
Epidemiology
Vitamin-D concentrations, cardiovascular risk and events - a review of epidemiological evidence. Reviews in Endocrine and Metabolic Disorders, Vol. 18, Issue. 2, p. 259. [cambridge.org]
Epidemiology of dilated cardiomyopathy. A prospective post-mortem study of 5252 necropsies. The Heart Muscle Disease Study Group. Eur Heart J. 1997 Jan. 18(1):117-23. [Medline]. Matsumura Y, Takata J, Kitaoka H, Kubo T, Baba Y, Hoshikawa E, et al. [emedicine.medscape.com]
Epidemiology In contrast to coronary heart disease having a higher incidence in the elderly, cardiomyopathies can occur at younger ages. [patient.info]
B 9 Epidemiology In 2006, the AHA classified cardiomyopathies as primary (i.e., genetic, mixed, or acquired) or secondary (e.g., infiltrative, toxic, inflammatory). 1 The four major types are dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive [aafp.org]
Pathophysiology
PubMed View Article Google Scholar Abraham JR, Butany J, Leong S, Luk A, Phillips K, Soor GS: Cocaine cardiotoxicity a review of the pathophysiology, pathology, and treatment options. Am J Cardiovasc Drugs. 2009, 9 (3): 177-196. 10.1007/BF03256574. [bmcresnotes.biomedcentral.com]
Further studies are needed in order to understand the pathophysiology and mechanism of cardiomyopathy associated with baclofen withdrawal syndrome. [radcliffecardiology.com]
Cardiomyopathies may be classified as either primary or secondary, on the basis of etiology, or on the pathophysiology of the lesion: hypertrophic, dilated, or restrictive. [icd10data.com]
Cardiomyopathies may be classified as either primary or secondary, on the basis of etiology, or on the pathophysiology of the lesion: hypertrophic, dilated, or restrictive. [ NCIT : C34830 ] Synonyms: extrinsic cardiomyopathy, [X]Cardiomyopathy in other [ebi.ac.uk]
Additionally, arrhythmias and chest pain may be present. [10] The pathophysiology of cardiomyopathies is better understood at the cellular level with advances in molecular techniques. [en.wikipedia.org]
Prevention
Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endcorinol Metab, February 2016, 101 (2):394-415 3. Maiya S. [imj.ie]
Vitamin D and cardiovascular disease prevention. Nature Reviews Cardiology, Vol. 13, Issue. 7, p. 404. CrossRef Google Scholar Reid, Ian R 2016. What diseases are causally linked to vitamin D deficiency?. [cambridge.org]
Is It Possible to Prevent Cardiomyopathy? Cardiomyopathy is a term that describes the end result of many diseases and illnesses. [emedicinehealth.com]
Prevention In many cases, cardiomyopathy cannot be prevented. However, there are some types of cardiomyopathy that can be avoided, such as those that are caused by excessive alcohol or drug use. [mydr.com.au]
Specific inhibitors and promoters of calcium action in the excitation-contraction coupling of heart muscle and their role in the prevention or production of myocardial lesions. In Calcium and the Heart, ed. [books.google.es]