"This Page is Dedicated to the One I Love" KAYLA who has totally changed my life. I will always Love You Kayla!! :):) You are My Life, My Love, and My Happiness!! One of the leading causes of deaths in America is heart disease. It can happen to any one at any time, at any age. On this page you will find information about the heart and other useful information along with a few links dealing with Cardiology. Cardiomyopathy was something I wasn't familiar with till loving Kayla. A special thank you to Lisa Salberg for answering my email. Visit her page: Hypertrophic Cardiomyopathy Association Cleveland Clinic Welcome page HYPERTROPHIC CARDIOMYOPATHY Facts about Cardiomyopathy More facts about Cardiomyopathy Cardiac Center - Cardiomyopathy/heart failure Hypertrophic Cardiomyopathy Cardiomyopathy Health Watch - Cardiomyopathy The following information is from the book "Yale University School of Medicine HEART BOOK Hypertrophic Cardiomyopathy This rare disease is the second most common type of Cardiomyopathy.Hypertrophic Cardiomyopathy is also known as idiopathic hypertrophic subaortic stenosis (IHSS) or asymmetric septal hypertrophy (ASH). The disease is characterized by a disorderly growth of heart muscle fiberscausing the heart chambers to become thick-walled and bulky. Allthe chambers affected, but the thickening is generally most striking in the walls of the left ventricle. Most commonly, one of the walls, the septum,which separates the right and left ventricles, is asymmetrically enlarged. The disoriented left ventricle contracts, but the supply of blood flow to the brain and other vital organs may be inadequate because blood is trapped within the heart during contractions. Mitral valve function is often disrupted by the structural abnormalities in the left ventricle with backward leakage of blood. Fainting during physical exertion is often the first and most dramatic symptom ofhypertrophic Cardiomyopathy. During periods of exertion, as the body stimulates the heart to beat more forcefully, blood has a greater tendency to become trapped within the vigorously contracting chambers. As a result, the person may faint or, in extreme cases die. Unexplained death during athletic activity always leads physicians to suspectun diagnosed Hypertrophic Cardiomyopathy. Several world-class athletes have suffered this type of death in the past few years. Complications of Hypertrophic Cardiomyopathy The walls of the hypertrophied heart are not always adequately nourished by blood vessels. This leads to muscle injury and scarring-a common complication of hypertrophic Cardiomyopathy. In advanced stages of the disease, the thickened, deformed, and scarred walls of the heart prevent the chambers from contracting effectively and filling up completely, leading to severe loss of heart function. Sudden death-the most unpredictable and devastating complication of this type of Cardiomyopathy-is the most commonly caused by ventricle fibrillation, abnormally fast and disorganized contractions of the left ventricle that interfere with effective pumping. The hypertrophied heart is prone to fibrillation because the disorderly overgrowth of muscle creates abnormal sites and pathways for the heart's electrical activity. Causes of Hypertrophic Cardiomyopathy Hypertrophic Cardiomyopathy is usually congenital. In half of the cases , the patient has in herited and abnormal gene from one parent. The pattern of genetic transmission is termed "auto somal dominant." This means that a copy of the gene from only one parent is needed for the disease to develop in the child. However, some siblings in the family may carry the gene but have hardly any trace of Hypertrophic Cardiomyopathy while others may die at a young age. In the rest of the cases, neither parent carries a gene for hypertrophic Cardiomyopathy,and the child is believed to develop the disease because of a spontaneous gene mutation. Symptoms of Hypertrophic Cardiomyopathy People with Hypertrophic Cardiomyopathy may experience a variety of symptoms during the course of the disease. Some have absolutely no symptoms for years and are only diagnosed after having and electrocardiogram for another reason, or when they come for an examination because a family member is known to carry the disease. Sometimes the disorder is detected for the first time at autopsy after the patient's death. Although predisposition for developing hypertrophic Cardiomyopathy is present from birth, the abnormal heart muscle proliferation may actually began during adolescent growth spurt. In such cases symptoms may develop rather abruptly during teenage years. Fainting upon exertion and chest pain similar to the angina of coronary artery disease may be early symptoms of hypertrophic Cardiomyopathy. Some patients experience palpitations because of abnormal heart rhythms. Eventually, symptoms of congestive heart failure may become prominent. Diagnosis of Hypertrophic Cardiomyopathy The most important diagnostic tool in assessing hypertrophic Cardiomyopathy is echocardiography It provides images and reveals blood flow patterns that allow physicians to physicians to identify the distinctive abnormalities in the heart walls and valves. Other characteristic features of the disease are often recorded an chest X-rays, electrocardiograms, and during cardiac catheterization. Treatment When hypertrophic Cardiomyopathy is severe, patients are advised to limit stressful physical activity, particularly strenuous competitive sports . They may also be given drugs to relieve symptoms. Traditionally, drugs called beta blockers have been used to prevent rapid heartbeat and decrease the excessive force of contractions. Antiarrhythmic drugs are often prescribed to treat abnormal heart rhythms. In the past decade, calcium channel blockers, particularly verapamil(Calan), have been shown to be especially effective for relief of symptoms. Like beta blockers calcium antagonists reduce the force of the heart's contractions. but they also increase the flexibility of the bulky heart chambers. These combined effects increase the efficiency of pumping and reduce congestion. Surgery may be performed in people with hypertrophic Cardiomyopathy whose symptoms are not relieved by medications. The surgeon may remove the excess muscle tissue that obstructs the blood flow to the heart chamber. Prognosis The course of hypertrophic Cardiomyopathy varies. The condition may remain stable over decades or may progress slowly. Approximately 4 percent of people with the disease die annually, most of them from sudden death, which may occur at any stage of the disease. The younger the age at which the disease appears, the higher the risk of sudden death. Special Risks of Hypertrophic Cardiomyopathy for Young Athletes People who regularly participate in strenuous physical exercise, such as profession alathletes or those who train for marathons, may experience changes in the function and structure of their hearts. These adaptations, which include a slower than normal heart beat and an overall enlarged heart, enable the heart to deliver more oxygen to the tissues in the limbs in order to sustain and enhance athletic performance. Heart muscle thickness may increase in an athlete's heart. Generally, this is nothing to wrorry about, but athletes - especially teenagers-should be monitored to ensure that hypertrophic Cardiomyopathy is not underlying cause of heart enlargement.. A good deal of publicity was given to this disease when Hank Gathers, the college basketball star, died suddenly in 1990 while playing in a conference championship game for Loyola Marymount in Los Angeles. Gathers was known to have and enlarged heart and was taking medication at the time of his death. Most often, though, a young athlete with this condition is not aware of it. Although these incidents seem to make headlines frequently, they are relatively rare.According to the American Journal of Diseases of Children, each year there are 1 or 2cases per 200,000 athletes 30 years old or younger. Of those few cases, hypertrophic cardiomyopathy is involved about 60 percent of the time. Even so, anyone who begins participating in a new sport should undergo a complete medical history and physical examination-including orthopedics, neurologic, and cardiovascular assessment. If hypertrophic Cardiomyopathy is diagnosed, the athlete should avoid strenuous activity Hypertrophic Cardiomyopathy Caused by Drug Therapy A number of drugs can have toxic effects on the heart. Perhaps most damaging are the chemotherapy drugs doxorubicin (Adriamycin and Rubex) and daunorubicin (Cerubidine).Although they are effective in the treatment of leukemia and other cancers larger doses can be toxic to heart muscle. Changes in the radio-nuclide angiocardiogram(Chapter 10)may help detect this type of reaction. Drugs used to treat emotional and psychiatric problems can also alter heart function. Phenothiazine drugs such as chlorpromazine(Thorazine) and thioridazine ( Mellaril) andtricyclic antidepressant drugs such as imipramine ( Tofranil) and amitryptline (Endep and Elavil) may cause electrocardiograph abnormalities and heart rhythm disorders. If possible, these drugs should be avoided by anyone with a history of heart disease. In any case, people taking these drugs, especially large or continuous doses of them, should undergo heart examinations, including electrocardiograms, to detect toxic effects. If these are detected, the drugs will most often be discontinued, and alternate treatment will be instituted. Cardiomyopathy, Dilated Background: Cardiomyopathy is a broad term which basically means a subacute or chronic disorder of the myocardium. However it is also used to refer to a group of systemic diseases and processes which are toxic to or alter the myocardium. The cardiomyopathies are divided into three types (dilated, hypertrophic and restrictive). Of theses dilated Cardiomyopathy is the most common. Dilated Cardiomyopathy represents a large subset of congestive heart failure cases, being differentiated logistically but not necessarily physiologically, from ischemic and hypertensive heart disease. For the purposes of this text dilated Cardiomyopathy will refer to the subset of congestive heart disease with systolic dysfunction excluding hypertension or ischemic heart disease. Pathophysiology: The definition of dilated Cardiomyopathy is complex and rests in the pathophysiology. Apoptosis or programmed cell death has been reported in clinical and experimental dilated Cardiomyopathy, which is characterized by depressed systolic function or systolic pump failure, cardiomegaly, and ventricular dilatation. Reduced left ventricular contractile force leads to decreased cardiac output which results in increased residual volumes in both end systole and end diastole. Low cardiac output cause upregulation of the sympathetic nervous system and the renin-angiotensin axis. This causes a release of vasopressin and atrial naturetic peptide. The result of stimulation of these hormonal tracts is volume expansion which induces vasocontriction which, in turn, further decreases cardiac output. Treatment for this disorder attempts to breakdown this viscious cycle. Frequency: In the U.S.: The incidence of congestive heart failure which is largely dilated Cardiomyopathy is 400,000 cases per year with a prevalence of 2-3 million people in the U.S. being afflicted by this disease process. Mortality/Morbidity: The Framingham study found that 5 years after the initial presentation of congestive heart failure that 42% of women and 62% of men were dead. The worse their condition at the time of diagnosis the worse their chances of long-term survival. Hyponatremia at the time of presentation was found to be a marker of increased stimulation of the renin/angiotensin axis and worsening of the disease course and prognosis. Age: The elderly represent a large subsection of the population with this disease, 3-5% of the elderly have congestive heart failure making it the most common discharge diagnosis among the elderly. The Heart and How It Works Heart Attack - Signals and Action Risk Factors for Heart Disease Email Shoey & Kayla Misc. Cardiology Links American Heart Association Cardiac Rehabilitation and Prevention Professional Information Heart Information Network: General Cardiology American College Of Cardiology Children's Hospital Medical Center (Cincinnati) Australian Cardiology Index Hardin MD Cardiology Links Cardiology Compass Cardiology Internet Resources Links: Educational & Imaging More Information
"This Page is Dedicated to the One I Love" KAYLA who has totally changed my life. I will always Love You Kayla!! :):) You are My Life, My Love, and My Happiness!!
One of the leading causes of deaths in America is heart disease. It can happen to any one at any time, at any age. On this page you will find information about the heart and other useful information along with a few links dealing with Cardiology. Cardiomyopathy was something I wasn't familiar with till loving Kayla.
A special thank you to Lisa Salberg for answering my email.
Visit her page: Hypertrophic Cardiomyopathy Association
Cleveland Clinic Welcome page
Facts about Cardiomyopathy
More facts about Cardiomyopathy
Cardiac Center - Cardiomyopathy/heart failure
Hypertrophic Cardiomyopathy
Cardiomyopathy
Health Watch - Cardiomyopathy
The following information is from the book "Yale University School of Medicine HEART BOOK
This rare disease is the second most common type of Cardiomyopathy.Hypertrophic Cardiomyopathy is also known as idiopathic hypertrophic subaortic stenosis (IHSS) or asymmetric septal hypertrophy (ASH). The disease is characterized by a disorderly growth of heart muscle fiberscausing the heart chambers to become thick-walled and bulky. Allthe chambers affected, but the thickening is generally most striking in the walls of the left ventricle. Most commonly, one of the walls, the septum,which separates the right and left ventricles, is asymmetrically enlarged. The disoriented left ventricle contracts, but the supply of blood flow to the brain and other vital organs may be inadequate because blood is trapped within the heart during contractions. Mitral valve function is often disrupted by the structural abnormalities in the left ventricle with backward leakage of blood. Fainting during physical exertion is often the first and most dramatic symptom ofhypertrophic Cardiomyopathy. During periods of exertion, as the body stimulates the heart to beat more forcefully, blood has a greater tendency to become trapped within the vigorously contracting chambers. As a result, the person may faint or, in extreme cases die. Unexplained death during athletic activity always leads physicians to suspectun diagnosed Hypertrophic Cardiomyopathy. Several world-class athletes have suffered this type of death in the past few years.
The walls of the hypertrophied heart are not always adequately nourished by blood vessels. This leads to muscle injury and scarring-a common complication of hypertrophic Cardiomyopathy. In advanced stages of the disease, the thickened, deformed, and scarred walls of the heart prevent the chambers from contracting effectively and filling up completely, leading to severe loss of heart function. Sudden death-the most unpredictable and devastating complication of this type of Cardiomyopathy-is the most commonly caused by ventricle fibrillation, abnormally fast and disorganized contractions of the left ventricle that interfere with effective pumping. The hypertrophied heart is prone to fibrillation because the disorderly overgrowth of muscle creates abnormal sites and pathways for the heart's electrical activity.
Hypertrophic Cardiomyopathy is usually congenital. In half of the cases , the patient has in herited and abnormal gene from one parent. The pattern of genetic transmission is termed "auto somal dominant." This means that a copy of the gene from only one parent is needed for the disease to develop in the child. However, some siblings in the family may carry the gene but have hardly any trace of Hypertrophic Cardiomyopathy while others may die at a young age. In the rest of the cases, neither parent carries a gene for hypertrophic Cardiomyopathy,and the child is believed to develop the disease because of a spontaneous gene mutation.
People with Hypertrophic Cardiomyopathy may experience a variety of symptoms during the course of the disease. Some have absolutely no symptoms for years and are only diagnosed after having and electrocardiogram for another reason, or when they come for an examination because a family member is known to carry the disease. Sometimes the disorder is detected for the first time at autopsy after the patient's death. Although predisposition for developing hypertrophic Cardiomyopathy is present from birth, the abnormal heart muscle proliferation may actually began during adolescent growth spurt. In such cases symptoms may develop rather abruptly during teenage years. Fainting upon exertion and chest pain similar to the angina of coronary artery disease may be early symptoms of hypertrophic Cardiomyopathy. Some patients experience palpitations because of abnormal heart rhythms. Eventually, symptoms of congestive heart failure may become prominent.
The most important diagnostic tool in assessing hypertrophic Cardiomyopathy is echocardiography It provides images and reveals blood flow patterns that allow physicians to physicians to identify the distinctive abnormalities in the heart walls and valves. Other characteristic features of the disease are often recorded an chest X-rays, electrocardiograms, and during cardiac catheterization.
When hypertrophic Cardiomyopathy is severe, patients are advised to limit stressful physical activity, particularly strenuous competitive sports . They may also be given drugs to relieve symptoms. Traditionally, drugs called beta blockers have been used to prevent rapid heartbeat and decrease the excessive force of contractions. Antiarrhythmic drugs are often prescribed to treat abnormal heart rhythms. In the past decade, calcium channel blockers, particularly verapamil(Calan), have been shown to be especially effective for relief of symptoms. Like beta blockers calcium antagonists reduce the force of the heart's contractions. but they also increase the flexibility of the bulky heart chambers. These combined effects increase the efficiency of pumping and reduce congestion. Surgery may be performed in people with hypertrophic Cardiomyopathy whose symptoms are not relieved by medications. The surgeon may remove the excess muscle tissue that obstructs the blood flow to the heart chamber.
The course of hypertrophic Cardiomyopathy varies. The condition may remain stable over decades or may progress slowly. Approximately 4 percent of people with the disease die annually, most of them from sudden death, which may occur at any stage of the disease. The younger the age at which the disease appears, the higher the risk of sudden death.
People who regularly participate in strenuous physical exercise, such as profession alathletes or those who train for marathons, may experience changes in the function and structure of their hearts. These adaptations, which include a slower than normal heart beat and an overall enlarged heart, enable the heart to deliver more oxygen to the tissues in the limbs in order to sustain and enhance athletic performance. Heart muscle thickness may increase in an athlete's heart. Generally, this is nothing to wrorry about, but athletes - especially teenagers-should be monitored to ensure that hypertrophic Cardiomyopathy is not underlying cause of heart enlargement.. A good deal of publicity was given to this disease when Hank Gathers, the college basketball star, died suddenly in 1990 while playing in a conference championship game for Loyola Marymount in Los Angeles. Gathers was known to have and enlarged heart and was taking medication at the time of his death. Most often, though, a young athlete with this condition is not aware of it. Although these incidents seem to make headlines frequently, they are relatively rare.According to the American Journal of Diseases of Children, each year there are 1 or 2cases per 200,000 athletes 30 years old or younger. Of those few cases, hypertrophic cardiomyopathy is involved about 60 percent of the time. Even so, anyone who begins participating in a new sport should undergo a complete medical history and physical examination-including orthopedics, neurologic, and cardiovascular assessment. If hypertrophic Cardiomyopathy is diagnosed, the athlete should avoid strenuous activity
A number of drugs can have toxic effects on the heart. Perhaps most damaging are the chemotherapy drugs doxorubicin (Adriamycin and Rubex) and daunorubicin (Cerubidine).Although they are effective in the treatment of leukemia and other cancers larger doses can be toxic to heart muscle. Changes in the radio-nuclide angiocardiogram(Chapter 10)may help detect this type of reaction. Drugs used to treat emotional and psychiatric problems can also alter heart function. Phenothiazine drugs such as chlorpromazine(Thorazine) and thioridazine ( Mellaril) andtricyclic antidepressant drugs such as imipramine ( Tofranil) and amitryptline (Endep and Elavil) may cause electrocardiograph abnormalities and heart rhythm disorders. If possible, these drugs should be avoided by anyone with a history of heart disease. In any case, people taking these drugs, especially large or continuous doses of them, should undergo heart examinations, including electrocardiograms, to detect toxic effects. If these are detected, the drugs will most often be discontinued, and alternate treatment will be instituted.
Background: Cardiomyopathy is a broad term which basically means a subacute or chronic disorder of the myocardium. However it is also used to refer to a group of systemic diseases and processes which are toxic to or alter the myocardium. The cardiomyopathies are divided into three types (dilated, hypertrophic and restrictive). Of theses dilated Cardiomyopathy is the most common. Dilated Cardiomyopathy represents a large subset of congestive heart failure cases, being differentiated logistically but not necessarily physiologically, from ischemic and hypertensive heart disease. For the purposes of this text dilated Cardiomyopathy will refer to the subset of congestive heart disease with systolic dysfunction excluding hypertension or ischemic heart disease.
Pathophysiology: The definition of dilated Cardiomyopathy is complex and rests in the pathophysiology. Apoptosis or programmed cell death has been reported in clinical and experimental dilated Cardiomyopathy, which is characterized by depressed systolic function or systolic pump failure, cardiomegaly, and ventricular dilatation. Reduced left ventricular contractile force leads to decreased cardiac output which results in increased residual volumes in both end systole and end diastole. Low cardiac output cause upregulation of the sympathetic nervous system and the renin-angiotensin axis. This causes a release of vasopressin and atrial naturetic peptide. The result of stimulation of these hormonal tracts is volume expansion which induces vasocontriction which, in turn, further decreases cardiac output. Treatment for this disorder attempts to breakdown this viscious cycle.
Frequency:
Mortality/Morbidity: The Framingham study found that 5 years after the initial presentation of congestive heart failure that 42% of women and 62% of men were dead. The worse their condition at the time of diagnosis the worse their chances of long-term survival.
Age: The elderly represent a large subsection of the population with this disease, 3-5% of the elderly have congestive heart failure making it the most common discharge diagnosis among the elderly.
Email Shoey & Kayla
Misc. Cardiology Links
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