Question

Your clinic patient has been newly diagnosed with hypertensive cardiomyopathy. Explain this disorder in lay terms

Answer 1

# Hypertensive cardiomyopathy (HTN-CM) is the complication of persistent systemic hypertension . It is the structural cardiac muscle disorder along with left ventricular hypertrophy associated with systolic and diastolic dysfunction.

# Pathophysiology :-

Decreased stroke volume stimulates the sympathetic nervous system and the renin -angiotensin -aldosterone response, resulting in increased systemic vascular resistance and increased sodium and fluid retention,which places an increased workload on the heart and leads to heart failure.

#Clinical manifestation are:-

- Shortness of breath

- paroxysmal nocturnal dyspnea

- cough and orthopnea

- fluid retention, edema (peripheral)

- nausea , dizziness ,chest pain , syncope

- jugular vein distension ,pitting edema , hepatosplenomegaly

- tachycardia and extra heart sounds

# Diagnosis :-

- ECG

-ECHO

- Cardiac MRI

- Chest X-ray

- Cardiac catheterization

# Treatment :-

-1 Main focus is on the precipitating factors like hypertension , unhealthy diet etc .

- 2 providing a low sodium diet

- 3 pharmacological therapy include :-

- beta blockers( propanalol ,etc)

- ACE inhibitors( enalapril, etc)

- Calcium channel blockers( amlodepine ,etc)

- Vasodilator( nitroglycerin ,etc)

- Anticoagulant( heparin , warfarin etc)

- IV infusions of dobutamine etc

- Cardiac glycosides and anti arrhythmias ( digitalis)

- 4 Surgical intervention :-

- Implantable cardioverter defibrillator

- Myectomy

- Heart transplantation

- Left ventricular assist devices , all these surgical intervention are considered when heart failure has progressed and treatment is no longer effective.