Cardiomegaly

One of the heart disorder..it may leads to death of the person

1. CARDIOMEGALY SUBMITTED BY, SHEELA M JOHN 2 ND YEAR MSC NURSING

2. INTRODUCTION Cardiomegaly is a medical condition in which the  heart is enlarged . It is more commonly referred to as an enlarged heart. Other common names for cardiomegaly is megacardia or megalocardia, but they all refer to the same thing. The causes of cardiomegaly vary from patient to patient,depending on each case. 

3. DEFINITION Cardiomegaly is a medical condition in which the heart is enlarged. It is more commonly referred to as an enlarged heart . An enlarged heart may not pump blood effectively, resulting in congestive heart failure.

4. ETIOLOGY Idiopathic: an enlarged heart can be caused by conditions that caused by conditions that cause heart to pump harder than usual or that damage heart muscle. Sometimes the heart enlarges and becomes weak for unknown reasons. Diseases of the heart muscle or heart valves , as the thickening and stiffening of heart muscles progresses, the heart may enlarge to try to pump more blood to the body. High blood pressure Arrhythmias: A congenital heart condition, damage from a heart attack or an abnormal heartbeat can cause heart to enlarge. Infectious endocarditis, connective tissue disorders, certain medications or radiation treatments for cancer , the heart may enlarge. Pulmonary  hypertension .

5. Longstanding  anemia   (Low red blood cell count) Thyroid diseases. Pericardial effusion: Accumulation of fluid in the sac(pericardium) that contains the heart may cause heart to appear enlarged on a chest xray . Excessive iron in blood (hemochromatosis): It is a disorder in which the body doesn’t properly metabolize iron, causing it to build up in various organs, including heart. Rare diseases such as Amyloidosis (It is a condition in which abnormal proteins circulate in blood and may be deposited in heart, interfering with heart’s function and causing it to enlarge.

6. Viral infection of the heart. Pregnancy, with enlarged heart developing around the time of delivery (peripartum cardiomyopathy) Kidney diseases requiring dialysis HIV infection Alcohol or cocaine abuse Diabetes

7. RISK FACTORS High blood pressure : higher than 140/90 millimeters of mercury A family history of enlarged hearts or cardiomyopathy Coronary artery disease Congenital heart disease Valvular heart disease Heart attack

8. CLASSIFICATION Ventricular hypertrophy (VH): It is  thickening  of the walls of a  ventricle (lower chamber)  of the  heart . Although  left ventricular hypertrophy  (LVH) is more common, rightventricular hypertrophy  (RVH), as well as concurrent hypertrophy of both ventricles can also occur.

9. Atrial enlargement   It refers to a condition where the  left atrium  or  right atrium  of the heart is larger than would be expected. It can also affect both atria.

10. Dilated cardiomyopathy   It is the most common type of cardiomegaly. In this condition, the walls of the left and/or right ventricles of the heart become thin and stretched. The result is an enlarged heart. In the other types of cardiomegaly, the heart's large muscular left ventricle becomes abnormally thick. Hypertrophy is usually what causes left ventricular enlargement.

11. Hypertrophic cardiomyopathy   It is typically an inherited condition

12. SIGNS AND SYMPTOMS Heart palpitations Severe shortness of breath (especially physically active)- irregulary unable to catch one’s breath. Chest pain Fatigue Swelling in legs Increased abdominal girth Weight gain Edema Fainting

13. DIAGNOSTIC EVALUATION Chest xray Electrocardiogram Echocardiogram Stress test Cardiac computerized tomography or MRI Blood test Cardiac catheterization Biopsy

14. MEDICAL MANAGEMENT Diuretics : To lower the amount of sodium and water in the body, which can help lowers the pressure in the arteries and heart. Angiotensin-converting enzyme inhibitors (ACE) : To lower the BP and improves the heart pumping ability. Angiotensin receptor blockers (ARBs): To provide the benefits of ACE inhibitors for those who cannot take ACE inhibitors.

15. Beta blockers: To lower blood pressure and improve heart function. Digoxin : To help improve the pumping function of the heart and lessen the need for hospitalization for heart failure. Anticoagulants: To reduce the risk of blood clots that could cause a heart attack or stroke. Anti- arrythmics : To keep the heart beating with a normal rhythm.

16. SURGICAL MANAGEMENT Pacemaker: It coordinates the contractions between the left and right ventricle. In people who may be at risk of serious arrythmias, drug therapy or an implantable cardioverter- defibrillator may be an option. Heart valve surgery: to remove the valve and replace it with either an artificial valve from a pig, cow or deceased human donor Coronary bypass surgery Left ventricular assist device Heart transplant

17. COMPLICATIONS Heart failure Blood clots Heart murmur Cardiac arrest Sudden death

18. LIFESTYLE MODIFICATIONS Quit smoking. Lose excess weight. Limit salt in the diet. Control diabetes. Monitor blood pressure. Get modest exercises, after discussing with the doctor the most appropriate program of physical activity. Avoid or eliminate alcohol and caffeine. Try to sleep eight hours nightly.

19. CONCLUSION Cardiomegaly   (megacardia or megalocardia) is a medical condition in which the heart is enlarged. As such, it is more commonly referred to simply as "having an  enlarged heart ". It is not a disease, but rather a condition that can result from a host of other diseases such as obesity or coronary artery disease.

20. BIBLIOGRAPHY Brunner and Sudharth’s .Textbook of Medical Surgical nursing: Lippincott Publishers: Page no.1208-1212. www.wikipedia.com www.mayoclinic.com www.currentnurses.com

21. https://www.youtube.com/watch?v=RNw3SnfLfYQ