The Disease Process of Cardiomyopathy - Term Paper Example

?Cardiomyopathy The Disease Process of Cardiomyopathy In APA Style Cardiomyopathy 2 Introduction This paper discusses the nursing assessment and implications of cardiomyopathy. It also touches on the details and the different types of the disease and gives us a background of the differences of one from the other. As you read along, you will have a good grasp of the disease in relation to your course. What is Cardiomyopathy? Cardiomyopathy is a complex disease process that involves the heart muscles of a person of any age. It is describes as the weakening or the deterioration of the muscles of the heart. It is included in the list of diseases that has the highest morbidity rate in the world’s aging population. The degree and the time course of the disease vary and do not coincide with the linear expression of symptoms. People suffering from such disease normally have asymptomatic left ventricular systolic dysfunction, left ventricular diastolic dysfunction or both. Congestive heart failure (CHF) is the state of the disease that is expressed when the balance between malfunction and compensation is disordered such that cardiac output can no longer be maintained at normal left ventricular filling pressures. (Giles & Sander, 1988, p 16) Types of Cardiomyopathy There are three types of cardiomyopathy; dilated, hypertrophic and unclassified cardiomyopathy. Dilated cardiomyopathy is the most common among the three types. In this type, the heart’s main pumping chamber – the left ventricle, coming from the term ‘dilated’, grows bigger than its normal size. The ability to pump blood throughout the body becomes less forceful, making the blood flow uneasily. (Giles & Sander, 1988, p 24) Although as mentioned above, Cardiomyopathy 3 cardiomyopathy can occur to people of any ages; this is most commonly seen in middle-aged people and is more often to occur in men. Some people who have this type of cardiomyopathy acquire the disease hereditary. The second type of cardiomyopathy is hypertrophic. This type of the disease entails the abnormal thickening of the heart muscle, affecting the main pumping chamber of the heart – the left ventricle. As the thickening occurs, it affects the blood circulation in the body due to the stiffening and the shrinking of the heart’s pumping chamber, which affects the ability of the heart to deliver blood to the entire body. Just like any other types of this disease, this may develop in any ages but it becomes more visible during childhood. (Giles & Sander, 1988, p 33) Normally, people who acquire this disease have a family history and more often than not, linked to some genetic mutations. Affected patients of this type of cardiomyopathy may be asymptomatic or may have signs of hindlimb paralysis or acute dyspnea. Examinations demonstrate abnormal heart sounds; from soft to prominent systolic cardiac murmurs and gallop heart sounds. The last type of cardiomyopathy is unclassified or better known as restrictive cardiomyopathy. The heart muscles of people who develop this type of disease become rigid and less elastic, which tends the heart to not expand properly to be able to contain blood between heartbeats. This is common in older people although it can develop in any ages just like the other types. This type is the least common among the three and can occur without known reason – idiopathic. (Giles & Sander, 1988, p 41) This can also be caused by other diseases that affect the heart. This type includes patients with visible abnormalities in the myocardium on echocardiography that do not fit into the other two types. This type of disease is also seen in cats. As mentioned above, Cardiomyopathy 4 restrictive cardiomyopathy have unknown causes. Nursing Intervention The disease is defined as ventricular dilation, systolic contractible dysfunction, low cardiac output and other congestive heart failure symptoms (crackles, edema, etc.) The decrease in the blood supply comes hand in hand with the decrease of amount of oxygen supply in the body. This can lead to kidney failure, abdominal fullness and constipation, which justifies the diagnosis: poor nutritional habits – eating less than what the body needs, risk of aspiration, constipation and risk for ineffective renal perfusion. Nursing interventions must be dealt with intensively. It is worth pointing out that nursing implementation should be delivered by following a standard operating procedure or protocol that is surveyed by a registered nurse. Studies show that nursing interventions are required for young patients using an intra-aortic balloon pump. This includes the recording of the intra-aortic balloon parameters, vital signs like pulse, perfusion, etc, urine output and laboratory results needed for the patient’s care. Studies also add that a specialized approach is an effective way to nurse ill patients. (Sutton, 2008, p 95) Nurses should monitor cardiovascular parameters such as heart rate, rhythm, blood pressure, respiratory rates, urine output and renal function. This also includes the monitoring of the BUN and the creatinine, bowel sounds assessments, infection prevention, perineal contamination of catheter site, temperature and potential bleeding. Chest x-rays and arterial blood gases should also be conducted on a daily basis. (Pearson, 1997, p 63) Nursing a child with an intra-aortic balloon requires not just an experienced nurse but also a professional and rational one who can make objective decisions when faced with the diagnosis Cardiomyopathy 5 and interventions stated above. To assure the effectiveness of the interventions discussed, new studies aiming at the nursing activities and other approaches are suggested. Causes of Cardiomyopathy Except for restrictive cardiomyopathy, the common causes of the disease are as follows: Heart valve problems Chronic heart rate High blood pressure (long-term) Metabolic diseases (thyroid, diabetes, etc) Vitamin and mineral deficiencies (thiamin, selenium, calcium and magnesium) Excessive use of alcohol resulting to heart failure, high blood pressure, etc. Abuse of anti-depressants ( cocaine, tricyclic anti-depressants) Chemotherapy drugs Viral infections that may trigger heart problems Hemochromatosis (iron build-up in the heart muscle) Pregnancy (Lichtenberg, 2006, p 78) Treatment Not all patients who acquire cardiomyopathy need to be treated. Those who don’t have symptoms may not need one. Sometimes, dilated cardiomyopathy that becomes suddenly visible on people may go away on its own even without undergoing any type of treatment. A number of medicines are used to treat the disease. These are as follows: Cardiomyopathy 6 ACE inhibitors, angiotensin II receptor blockers, beta blockers, calcium channel blockers to lower blood pressure Electrolytes to help maintain fluid levels in the body Water pills to remove excess fluid and sodium from the body Anticoagulants that prevent blood clots in the body. These blood thinners help minimize or prevent the body from having blood clots. Corticosteroids to reduce inflammation in the body Another way of treating cardiomyopathy is through surgery. There are several types of surgeries that eliminate or reduce the implications of the disease. One of which is septal myectomy or open-heart surgery. This is conducted to patients who have severe cardiomyopathy, normally for younger patients and for those whose medicines aren’t working for them. Another type of treatment is a pacemaker. It is one of surgically implanted devices that are used to control abnormal heart rhythms. This prompts the heart to beat at a normal rate. Oftentimes, doctors use a biventricular pacemaker, which coordinates contractions between the left and the right ventricle of the heart. Heart transplant is another way to treat cardiomyopathy. This procedure is considered as the last resort to treat this disease. This process is done by removing the diseased heart with a healthy heart from a diseased donor. This option is considered when all else fails – end stage. Other procedure such as non-surgical are also conducted when other ways are tried but failed. Doctors may conduct alcohol septal ablation in which ethanol is injected through a catheter into the small artery that is responsible for blood delivery to the thickened area of the heart. This Cardiomyopathy 7 process kills the cells and the thickened tissues shrink to its normal size. (Lind & Semsarian, 2006) Conclusion A healthy lifestyle is the best way to avoid developing any disorder or disease such as cardiomyopathy. Treated patients who had this disease are advised to change their lifestyles to a healthy one in order to prevent the disease from recurring even if the heart has been replaced by a health one. Remember that a healthy heart, no matter how new, can still develop heart problems when abused. Giles, T. D., & Sander, G. E. (1988).Cardiomyopathy. Littleton, Mass: PSG. Sutton, A. L. (2008). Surgery sourcebook: Basic consumer health information about common inpatient and outpatient surgeries. Detroit, MI: Omnigraphics. Lichtenberg, M. (2006). The open heart companion: Preparation and guidance for open-heart surgery recovery. Sante Fe, NM: Open Heart Pub. Pearson, M. L., & National Institute of Nursing Research (U.S.). (1997). An Implicit review method for measuring the quality of in-hospital nursing care of elderly congestive heart failure patients. Santa Monica, Calif. (1700 Main Street, P.O. Box 2138, Santa Monica 90407-2138: RAND. Lind, J. M., Chiu, C., & Semsarian, C. (January 01, 2006). Genetic basis of hypertrophic cardiomyopathy. Expert Review of Cardiovascular Therapy, 4, 6, 927-34. Read More