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心肌病:概述。

Cardiomyopathy: an overview.

机构信息

The Ohio State University, 456 W. 10th Ave., Columbus, OH 43210, USA.

出版信息

Am Fam Physician. 2009 May 1;79(9):778-84.

Abstract

Cardiomyopathy is an anatomic and pathologic diagnosis associated with muscle or electrical dysfunction of the heart. Cardiomyopathies represent a heterogeneous group of diseases that often lead to progressive heart failure with significant morbidity and mortality. Cardiomyopathies may be primary (i.e., genetic, mixed, or acquired) or secondary (e.g., infiltrative, toxic, inflammatory). Major types include dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, and arrhythmogenic right ventricular cardiomyopathy. Although cardiomyopathy is asymptomatic in the early stages, symptoms are the same as those characteristically seen in any type of heart failure and may include shortness of breath, fatigue, cough, orthopnea, paroxysmal nocturnal dyspnea, and edema. Diagnostic studies include B-type natriuretic peptide levels, baseline serum chemistries, electrocardiography, and echocardiography. Treatment is targeted at relieving the symptoms of heart failure and reducing rates of heart failure-related hospitalization and mortality. Treatment options include pharmacotherapy, implantable cardioverter-defibrillators, cardiac resynchronization therapy, and heart transplantation. Recommended lifestyle changes include restricting alcohol consumption, losing weight, exercising, quitting smoking, and eating a low-sodium diet.

摘要

心肌病是一种与心脏肌肉或电功能障碍相关的解剖学和病理学诊断。心肌病是一组异质性疾病,常导致进行性心力衰竭,具有较高的发病率和死亡率。心肌病可以是原发性的(即遗传、混合或获得性的)或继发性的(例如浸润性、毒性、炎症性的)。主要类型包括扩张型心肌病、肥厚型心肌病、限制型心肌病和致心律失常性右室心肌病。尽管心肌病在早期阶段可能无症状,但症状与任何类型心力衰竭的特征相同,可能包括呼吸急促、疲劳、咳嗽、端坐呼吸、阵发性夜间呼吸困难和水肿。诊断性研究包括 B 型利钠肽水平、基线血清化学、心电图和超声心动图。治疗旨在缓解心力衰竭症状,降低心力衰竭相关住院率和死亡率。治疗选择包括药物治疗、植入式心脏复律除颤器、心脏再同步治疗和心脏移植。推荐的生活方式改变包括限制饮酒、减肥、锻炼、戒烟和低盐饮食。

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