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Ischemic cardiomyopathy

2017-08-05

Ischemic cardiomyopathy is due to coronary atherosclerosis caused by long-term myocardial ischemia to diffuse fibrosis-based cardiomyopathy, also known as myocardial sclerosis or myocardial fibrosis. Ischemic cardiomyopathy coronary atherosclerosis serious, multiple multi-vessel disease, the heart gradually expanded, left ventricular function was impaired, left ventricular ejection fraction more than 35%. Clinical manifestations of arrhythmia and heart failure, it is also known as arrhythmia and heart failure type coronary heart disease.

Ischemic cardiomyopathy in Chinese medicine is "heart palpitations", "tingling", "edema", "asthma cough", "phlegm", "chest" and other areas.

Clinical manifestations

(A) congestive ischemic cardiomyopathy

1. Common in the elderly patients, there is a clear history of coronary heart disease, mostly male, the symptoms generally occur gradually. Angina is one of the main symptoms of patients, but with the emergence of heart failure, angina can gradually reduce or even disappear.

Have heart enlargement and heart failure performance. Tired dyspnea as a common symptom, severe cases may have sitting breathing and nocturnal paroxysmal dyspnea. Also often fatigue, weakness and other performance, late edema and abdominal distension can occur.

2. Physical examination can be found jugular vein engorgement, lung rales, liver increased. Heart enlargement, mainly to the left ventricle, apoplexy to the lower left shift. The first heart sound normal or low blunt, apical and can be heard and the third heart sound and fourth heart sound. Such as the merger of pulmonary hypertension, the pulmonary heart of the second heart sound hyperactivity. Apical often heard and systolic murmur, caused by mitral regurgitation. ECG showed sinus tachycardia, ventricular premature beats and atrial fibrillation and other arrhythmia performance.

(B) limited type of ischemic cardiomyopathy

1. Patients often have tired dyspnea and angina, so the activity is limited.

2. Patients may have no myocardial infarction.

3. have shortness of breath, fatigue and other symptoms.


Diagnostic points

(A) affirmative conditions

1. Have a clear history of coronary heart disease.

2. The heart is enlarged.

3. Signs of cardiac insufficiency and / or laboratory basis.

(B) the negative conditions

1. to exclude some complications of coronary heart disease such as ventricular aneurysm, ventricular septal defect and papillary muscle dysfunction caused by mitral regurgitation and arrhythmia caused by cardiac enlargement and heart failure.

2. Excluding other cardiomyopathy or other causes of cardiac enlargement and heart failure.


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