cardiomegaly.pptx, DEEPIKA.R, M. Sc nursing.

cardiomegaly.

1. cardiomegaly ​ DEEPIKA.R, M . Sc Nursing II- year, College of Nursing, Madras medical college, Chennai.

2. DEFINITION Cardiomegaly, also known as an enlarged heart, is a medical condition in which the heart becomes larger than its normal size. It is often referred to simply as “having an enlarged heart .” 2

3. The cardiac enlargement process can be generalized to all chambers or involve only the left or right heart chambers, or even a single chamber, depending on the location and type of underlying lesion(s). PRESENTATION TITLE 3

4. etiology

5. Etiology cont ,,, The most common causes of cardiomegaly are ISCHEMIC CARDIAC DISEASE AND The ischemic cardiac disease occurs when narrowed arteries, caused by fatty deposits that build up in arteries, prevent blood from getting to heart. HIGH BLOOD PRESSURE. CARDIOMYOPATHY Cardiomyopathy may be a progressive cardiac disease with several types. Diseases that damage the cardiac muscle can cause it to enlarge. The more damage that happens, the weaker and less able to pump the heart becomes.

6. Cont.., HEART VALVE DISEASE Infections, connective tissue diseases, and a few medications can damage the valves that keep blood flowing within the right direction through heart. When blood flows backwards, the heart needs to work harder to push it out. HEART ATTACK During heart failure, blood flow to a part of the heart is blocked completely. the shortage of oxygen-rich blood damages the heart muscle.

7. Cont ,,.. THYROID DISEASE The thyroid gland produces hormones that regulate the body’s metabolism. Both overproduction (hyperthyroidism) and underproduction (hypothyroidism) of those hormones can affect the pulse rate, blood pressure, and size of the heart. IRREGULAR CARDIAC RHYTHM (ARRHYTHMIA) If you have an irregular heartbeat, rather than beating in its familiar lub -dub pattern, the heart flutters or beats too slowly or quickly. An irregular cardiac rhythm can cause blood to back up within the heart and eventually damage the muscle.  

8. CONGENITAL CONDITIONS Congenital cardiomegaly may be a heart disorder born with. Congenital heart defects that cause this symptom to include: Atrial septal defect (ASD), a hole within the wall separating the two upper chambers of the heart Ventricular septal defect (VSD), a hole within the wall separating the two lower chambers of the heart  

9. Coarctation of the aorta, a narrowing of the aorta, the main artery that carries blood from the heart to the whole of the body Patent ductus botalli, a hole within the aorta

10. Cont ,... Ebstein’s anomaly, the issue with the valve that separates the two right chambers of the heart (atrium and ventricle) ” “

11. Tetralogy of Fallot (TOF), a mixture of birth defects that disrupt the regular flow of blood through the heart 11

12. Lung disease, including chronic obstructive pulmonary disease (COPD) Myocarditis Pulmonary hypertension Anemia Connective tissue diseases, like scleroderma Drug and alcohol use   Other possible causes of cardiomegaly include: 12

13. 13

14. Other possible causes of cardiomegaly include: 14

15. Development of cardiac remodeling and hypertrophy with genetic and non-genetic components. pathophysiological changes resulting in cardiomegaly include dilated hypertrophy, fibrosis, and contractile malfunction. Can cause cardiomyopathy or dilated cardiomyopathy. Mechanical stretching, circulating neurohormones and oxidative stress are significant changes in structural proteins and proteins that regulate excitation-contraction cardiomyopathy mutations result in a molecular phenotype of hyperdynamic contractility, poor relaxation, and increased energy consumption. Pathophysiology 15

16. High blood pressure : Having a blood pressure measurement above 140/90 millimeters of mercury. A family history of enlarged hearts or cardiomyopathy : If an instantaneous loved one, like a parent or sibling, has had cardiomegaly, you'll be more susceptible. Congenital cardiac disease : If you're born with a condition that affects the structure of your heart, you'll be at increased risk. Heart valve disease : the heart has four valves — aortic, mitral, pulmonary and tricuspid that open and shut to direct blood flow through your heart. Conditions that damage the valves may cause the heart enlargement.   Risk factors 16

17. A chest X-ray could also be the primary test your doctor does because it can show whether your heart is enlarged. Echocardiogram (ECG or EKG) uses sound waves to look for problems along with your heart’s chambers. Electrocardiogram monitors the electrical activity in your heart. It can diagnose irregular cardiac rhythm and ischemia. Blood tests check for substances in your blood produced by conditions that cause cardiomegaly like thyroid disease. A cardiovascular test involves walking on a treadmill or pedalling a stationary bike while your cardiac rhythm and breathing are monitored. It can show how hard your heart is functioning during exercise. DIAGNOSIS 17

18. A cardiovascular test involves walking on a treadmill or pedalling a stationary bike while your cardiac rhythm and breathing are monitored. It can show how hard your heart is functioning during exercise. Computerized tomography (CT) scans use X-rays to provide detailed images of your heart and other structures in your chest. It can help diagnose valve disease or inflammation. Magnetic resonance imaging (MRI) uses strong magnets and radio waves to provide pictures of your heart. DIAGNOSIS 18

19. In pregnancy During pregnancy, doctors can use a test called a fetal echocardiogram to diagnose heart defects within the unborn baby. This test uses sound waves to form pictures of the baby’s heart. Your doctor might recommend a fetal echocardiogram if you've got a family history of heart enlargement or heart defects, or if your baby has a genetic disease like Down syndrome. DIAGNOSIS 19

20. CHEST RADIOGRAPHY: 20

21. Treatment of mild cardiomegaly centers upon the treatment of the underlying condition. In moderate to severe cardiomegaly related to congestive heart failure, standard HF treatment guidelines also apply Patients at risk of cardiomyopathy have the benefit of risk factor modification like smoking cessation, limiting alcohol intake, weight loss, exercise, and consuming a healthy diet. Recommendations include treating any underlying risk factors like hypertension, dyslipidemia, and diabetes. Other underlying conditions, including obstructive sleep disorder, arrhythmias, anaemia , and thyroid disorders also require treatment. Treatment / Management 21

22. Patients with early-onset hypertrophic cardiomyopathy who are asymptomatic are managed with risk factor modification and also the addition of ACE inhibitor or ARB (if intolerant to ACE) and β-blocker if there's a history of MI or reduced ejection fraction (EF). Diuretics and salt restriction Ace inhibitor or arb (if intolerant to ace) and beta-adrenergic blocker if they have reduced ef . A hydralazine/nitrate combination when added to ace inhibitor, beta-adrenergic blocker, and diuretics improve outcomes Treatment / Management 22

23. An ICD (implantable cardioverter-defibrillator) is placed in patients with EF 35% CRT (cardiac resynchronization) is performed with or without ICD in patients with EF 35% or less and moderate to severe symptoms with evidence of left bundle branch block Patients with refractory congestive heart failure should receive optimal medical management. Also, eligible patients are often considered for cardiac transplantation and bridge therapy like ventricle assist device PRESENTATION TITLE 23

24. Complications of an cardiomegaly can include: Heart failure . An enlarged heart ventricle, one among the most serious kinds of cardiomegaly, increases the chance of heart failure. In heart failure, your cardiac muscle weakens, and also the ventricles stretch (dilate) to the point that the heart can't pump blood efficiently throughout your body.   24

25. Blood clots . Having cardiomegaly may cause you to more at risk of forming blood clots within the lining of your heart. If clots enter your bloodstream, they will block blood flow to vital organs, even causing an attack or stroke. Clots that develop on the right side of your heart may travel to your lungs, a dangerous condition called a pulmonary embolism (PE). PRESENTATION TITLE 25

26. Heart murmur . For people whose hearts are enlarged, two of the heart's four valves (the mitral and tricuspid valves) might not close properly because they become dilated, resulting in a backflow of blood. This flow creates sounds called heart murmurs. Although not necessarily harmful, heart murmurs should be monitored by your doctor. PRESENTATION TITLE 26

27. Cardiac arrest and sudden death . Sometimes cardiomegaly can result in disruptions in your heart's beating rhythm. Heart rhythms that are too slow to move blood or too fast to permit the heart to beat properly may result in fainting or, in some cases, cardiopulmonary arrest or sudden death. PRESENTATION TITLE 27

28. Eating a heart-healthy diet high in fruits and vegetables , lean poultry, fish, low-fat dairy, and whole grains Limiting salt, alongside saturated and trans fats Avoiding tobacco and alcohol Doing aerobic and strength-training exercises on most days of the week Checking your blood pressure and cholesterol level regularly, and working along with your doctor to lower them if they’re high prevention 28

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