CPD PRESENTATION CARDIOMYOPATHIES & SUDDEN DEATH

1. CPD PRESENTATION CARDIOMYOPATHIES & SUDDEN DEATH

2. “HEART ACTIVITY EITHER ELECTRICALLY (ARRHYTMIA) OR MECHANICALLY (HEART DEFECT) STOPS WORKING, RESULTING IN DEATH WITHIN MINUTES.”

3. IS A SPECIALISED MUSCLE THAT CONTRACTS REGULARLY & CONTINOUSLY PUMPS BLOOD TO THE BODY. • AN AVERAGE HEART BEATS 100,000 TIMES/DAY, PUMPING OVER 2,000 GALLONS (7,571 L) OF BLOOD.

4. DIVIDED INTO 4 CHAMBERS: RIGHT & LEFT VENTRICLES AND ATRIUM. ATRIA ARE THE RECIEVING CHAMBER OF THE HEART. VENTRICLES ARE THE PUMPING CHAMBERS IT HAS 4 VALVES TO ENSURE THAT THE BLOOD FLOW THROUGH THE HEART IS IN A FORWARD DIRECTION THE LEFT VENTRICLE IS THE LARGEST AS IT PUMPS BLOOD THROUGH TO THE WHOLE BODY: ORGANS, TISSUES AND CELLS

5. HEARTS 4 CHAMBERS BEAT IN AN ORGANISED MANNER GOVERNED BY ELECTRICAL IMPULSES ‘SA’ NODE IS CALLED HEARTS NATURAL ‘PACE MAKER’ A DISCHARGE FROM THIS PACE MAKER CAUSES THE HEART TO BEAT, HEART CONTRACT. EMOTIONAL & HORMONAL FACTORS CAN AFFECT HEART RATE OF DISCHARGE

6. THE ABNORMAL FUNCTION OF THE HEART MUSCLE NOT • CAUSED BY CORONARY ARTERY DISEASE (CAD), CONGENITAL • DISEASE, HYPERTENSION OR VALVULAR DISEASE. • IN THE HEART AFFECTED BY CM, EACH AND EVERY • HEART MUSCLE TISSUE IS DAMAGED, LEADS TO POOR • CONTRACTION • THE HEARTS OVERALL SYSTEMIC (PUMPING) FUNCTION • IS IMPAIRED. • IN AN ATTEMPT TO COMPENSATE FOR ITS REDUCED ABILITY TO PUMP, THE HEART MUSCLE HYPERTROPHIES (THICKENS),HEART CHAMBERS ENLARGE

7. First recognised more than a century ago but was only established as an accepted diagnosis in late 50’s. • -People everyday suffer from heart failure. Nearly 3million people are living with cardiomyopathies , • Approximately 400,000 are diagnosed with it each year.

8. HYPERTROPHIC (HCM) • DILATED (DCM) • RESTRICTIVE (RCM)

9. IS THE MOST COMMON CAUSE OF SUDDEN DEATH IN YOUNG PEOPLE. • -IT IS ESTIMATED THAT 10,000 PEOPLE IN THE UK HAVE THIS CONDITION. • -

10. “ THE IRREGULAR GROWTH OR THICKENING OF HEART MUSCLE, THAT AFFECTS THE MAIN BLOOD PUMPING MUSCLE.”

12. There are 4 types of heart muscle thickening pattern: • - Assymetrical septal hypertrophy without obstruction • - Assymetrical septal with obstruction • -Symmetrical Hypertrophy • -Apial Hypertrophy

13. Abnormality in genes: 45% mutation in â myosin heavy chain, 35% in cardiac binding C gene. • Heriditary: Automsomal Dominant • High blood pressure

14. i- heart muscle (usually around left ventricle), may become ‘stiff’ • ii- thickening marked in upper part of septum next to aortic valve • iii- may affect function of heart valve • iv- affects electrical conduction system of the heart- Wolffe-Parkinson-white syndrome • The heart muscle may thicken as a result of high blood pressure, but with HCM, the heart muscle thickens without an obvious cause!

15. REGGIE LEWIS – 27YR OLD BASKET BALL PLAYER 1993 BRITTANY MURPHY 32Y ACTRESS 2009 MARC VIVIEN FOE-FOOT BALLER 2003

17. THE MECHANISM OF DEATH IN A MAJORITY OF PATIENTS DYING OF SCD IS VENTRICULLAR FIBRILLATION (V-FIB) & AS A CONSEQUENCE THERE MAY BE NO SYMPTOMS ASSOCIATED WITH THEIR DEATH

18. CHEST PAINS(DURING & AFTER EXERCISE) OR AFTER MEALS • SHORTNESS OF BREATH & FATIGUE • SYNCOPE (FAINTING) • PALPITATIONS • LIGHT HEADEDNESS • DIZZINESS • SENSATION OF FEELING HEART BEAT

19. BNP : PROTEIN PRODUCED IN THE HEART • IRON LEVELS: RAISED LEVEL INDICATES OVERLOAD DISORDER “HEMOCHROMATOSIS” • LIPID: RATIO OF LDL & HDL IS AN INDICATOR OF RISK OF DEVELOPING PLAGUE IN ARTERIES • CARDIAC ENZYMES: CK-MB, CK-MM, CK-BB, LACTATE DEHYDROGENASE (LDH) • LOW RBC: FOR ANAEMIA CAN AFFECT PROGNOSIS • TROPONIN: TEST MYOCARDIA DAMAGE • AST: RAISED LEVEL INDICATES TISSUE DAMAGE

20. HEART MONITOR (HOLTER MONITOR) • CARDIAC CATHERIZATION • CHEST X-RAY • ELECTROCARDIOGRAPH (ECG) • ECHOCARDIOGRAM

21. THE HEART MUSCLE BECOMES ENLARGED AND CANNOT PUMP BLOOD EFFECTIVELY TO THE BODY IT AFFECTS LUNGS, LIVER & OTHER SYSTEMS

22. It is often a genetic condition caused by a mutation in one or more genes • Dilated cardiomyopathy is the most common type of the disease. It mostly occurs in adults aged 20 to 60. Men are more likely than women to have this type of cardiomyopathy. • In most cases, exact reason for DCM is not known. • Scientist have identified abnormal genes that are known to affect development of heart muscle, but they have also found many other genetic mutations that could be the cause, therefore, it makes it more difficult to do reliable genetic testing on individuals.

23. GENETIC : Barth Syndrome • VIRAL INFECTION: COXSACHIE B VIRUS • IMMUNE DISEASE • ALCOHOLISM • ANAEMIA • CORONARY ARTERY DISEASE • NUTRITIONAL DEFICIENCY • STRESS

24. -Arrythmias: atrial fibrillation • - Blood clots • -Chest pain • - Heart murmurs

25. BULGING NECK VEINS • COUGH • FAILURE TO THRIVE • FATIGUE, WEAKNESS, FAINT • LOSS OF APPETITE • LOW URINE PRODUCTION • PALPITATIONS • SHORTNESS OF BREATH • SWOLLEN FEET & ABDOMEN • CHEST PAIN

26. FULL BLOOD COUNT: ANAEMIA • LIVER FUNCTION TESTS • AST/ALT • ALKALINE PHOSPHATASE (ALP) • ECG • CHEST X-RAY • EXERCISE TEST • HOLTER MONITOR: MONITOR RHYTHM ACTIVITY • CARDIAC CATHERIZATION: TUBE INSERTED IN BLOOD VESSELS & DYE INJECTED THAT OUTLINES THE HEART & CORONARY ARTERIES (ANGIOGRAPH)

27. ACE INHIBITOR: DILATES BLOOD VESSELS • BETA BLOCKERS: PREVENT OVER PRODUCTION OF ADRENALINE • DIURETICS: REDUCES EXCESS FLUID BY INCREASING URINE PRODUCTION • DIGOXIN: CONTROLS HEART RATE & HELPS HEART MUSCLE TO CONTRACT BETTER • NUTRITIONAL SUPPLEMENTS

28. SUDDEN DEATH CAN HIT ANY PERSON OF ANY AGE. HOWEVER, LIFESTYLE CHANGES & REGULAR VISITS TO THE DOCTOR CAN GREATLY REDUCE THE RISK

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30. -www.cardiomyopathy.org • -www.bhf.org.uk/living...a.../cardiomyopathy • www.americanheart.org