Apical Ballooning ,HOCM, HTN

1. 3 Forms of Cardiomyopathy
Dr Ihab Suliman
Cardiology Morning Presentation
2 IM
7/6/2012

3. • Sinus Tachycardia + LVH

4. 70 years old lady post operative
for CA Colon

5. • Sinus Tachycardia, Low VoltaGE Limb
Leads Lateral STEMI

7. Sky High ST elevation with
Minimal Rise in Cardaic
Enzymes

8. • Sky High ST Elevation

12. • Cardiac Enzymes elevation is Much lower
than expected with Sky High STEMI

16. • Ballooned Apex

18. • Apical Balloon

21. Tako-tsubo Cardiomyopathy
• May account for up to 2% of suspected ACS
• In-hospital mortality ranges 0-8%
• Much more common in women (~90%),
especially postmenopausal women (>80% of
cases)
• Mean age 58-75 years
• Triggers: death of loved one, other catastrophic
news, devastating financial losses, natural
disasters, physical illness/ICU, etc.

22. Proposed Diagnostic Criteria
1. Transient a/dyskinesis of apical and midventricular
segments in association with regional wall motion
abnormalities that extend beyond the distribution of a
single epicardial vessel
2. Absence on angiography of obstructive coronary artery
disease or evidence of acute plaque rupture
3. New ST segment elevation or T wave inversions on
ECG
4. Absence of recent significant head trauma, intracranial
bleeding, pheochromocytoma, myocarditis, or
hypertrophic cardiomyopathy
Proposed by Bybee, et al. 2004. Annals of Internal Medicine. 141: 858-865.

25. The Second Form
70 years old with Papitations

26. • AF

28. • NSR in contrast to AF

33. • HTN , LVH

34. The Third
• 37 years old lady with Familial type of
Cardiomyopathy

40. • HOCM Different echo views

42. • AICD with atrial lead4 HOCM

43. • Hypertrophic cardiomyopathy is a genetic
disorder that is typically inherited in an
autosomal dominant fashion with variable
penetrance and variable expressivity.

44. • HCM is the leading cause of sudden
cardiac death in preadolescent and
adolescent children.
• The hallmark of the disorder is myocardial
hypertrophy that is inappropriate, often
asymmetrical, and occurs in the absence
of an obvious inciting hypertrophy
stimulus.

45. Complications of HCM may include the
following:
• Congestive heart failure or dilated
eventually in 10 %
• Ventricular and supraventricular
arrhythmias
• Infective mitral endocarditis
• Atrial fibrillation with mural thrombus
formation , AF worsen very much their
status ,occur up to 25-30, ATC is
important
• Sudden death

46. Cardiology staff at NGHA ,Riyadh ,ksa