Dilated cardiomyopathy surgery

We all know that medicines are effective for general diseases, but they can only alleviate more complicated diseases. If you want to cure or eradicate the disease, you have to choose surgery. Although it is painful, it works quickly and the possibility of recurrence is extremely small, so it is also a treatment method chosen by many people. So today I will talk to you about surgery for dilated cardiomyopathy.

Most of them are middle-aged people. The onset is usually slow, sometimes lasting more than 10 years. The main symptoms are congestive heart failure, among which shortness of breath and edema are the most common. Initially, shortness of breath occurs after labor or fatigue, and later shortness of breath also occurs during light activity or rest, or there are paroxysmal dyspnea at night. Patients often feel fatigued.

Physical examination shows accelerated heart rate, apex beat shifted to the lower left, there may be a lifting beat, the boundary of cardiac dullness expanded to the left, the third or fourth sound can often be heard, and the heart rate is a gallop rhythm when fast. Due to the enlargement of the heart chamber, there may be a systolic blowing murmur caused by relative mitral or tricuspid regurgitation, which will be alleviated as heart function improves. In late-stage cases, blood pressure is low, pulse pressure is small, and diastolic blood pressure may be slightly elevated when heart failure occurs. The presence of pulse alternans suggests left heart failure. The pulse is often weak.

There may be rales in both lungs in heart failure. When right heart failure occurs, the liver is enlarged and edema appears starting from the lower limbs. In the late stage, there may be pleural and abdominal effusion, and various arrhythmias may occur. High-degree atrioventricular block, ventricular fibrillation, and sinoatrial block can lead to Adams-Stokes syndrome, which is one of the causes of death. In addition, there may be embolism in the brain, kidneys, lungs, etc.

examine

1. X-ray examination

The most prominent manifestation is cardiac enlargement, mainly left ventricular enlargement, accompanied by right ventricular enlargement, and there may also be left and right atrium enlargement.

2. Electrocardiogram

Atrioventricular block of varying degrees, right bundle branch block is common. Extensive ST-T changes, high voltage in the left ventricle, left atrial hypertrophy, pathological Q waves due to myocardial fibrosis, and low voltage in each lead.

3. Echocardiography

The left ventricle was significantly enlarged, the left ventricular outflow tract was dilated, and the pulsation amplitude of the ventricular septum and left ventricular posterior wall was weakened.

4. Isotope examination

Isotope myocardial perfusion imaging mainly manifests enlargement of the heart chambers, especially the ventricles on both sides, and diffuse sparse myocardial imaging.

5. Endomyocardial Biopsy

The clinical manifestations and auxiliary examinations of dilated cardiomyopathy lack specificity. In recent years, endomyocardial biopsy has been carried out both at home and abroad, which has a high sensitivity but low specificity for diagnosing this disease.