الفهرس 
CLASSIFICATION AND PATHOPHYSIOLOGY OF CARDIOMYOPATHIESOnly 14 pages are availabe for public view
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Abstract
Cardiomyopathies are grouped into specific morphological and functional phenotypes. Theses phenotypes are :
• Hypertrophic cardiomyopathy (HCM).
• Dilated cardiomyopathy (DCM).
• Restrictive cardiomyopath (RCM).
• Arrhythmogenic Rt ventricular cardiomyopathy (ARVC).
• Unclassified cardiomyopathies. (Elliot p et al., 2008).
Patients with this underlying cardiomyopathy may present at any time for anesthesia or intraoperatively. It is essential that anesthesiologists understand the underlying pathology and the possible complications to better manage these patients. (Elliot p et al., 2008).
Hypertrophic cardiomyopahty is defined by the presence of increased ventricular wall thickness or mass in the absence of loading conditions with multiple familial and non familial causes and is usually diagnosed by presence of concentric or asymmetric hypertrophy of the left ventricle with outflow obstruction. (Fauci et al.,2008).
The anesthetic management of hypertrophic cardiomyopathy aiming to mainatain slightly elevated BP, slow heart rate, sinus rhythm & to prevent hypovolemia . (oliac LC et al., 2006).
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Dilated cardiomyopathy is defined by the presence of left ventricular dilatation and left ventricular systolic dysfunction in the absence of abnormal loading conditions or coronary artery disease. It’s caused by many familial and non familial causes. The
diagnosis is usually made by echogardiography. (Fauci et al.,2008).
The main complications of dilated cardiomyopathy are thrmboembolism & arrhythmias. The anesthetic goals include maintenance of preload, normal BP and avoidance of tachycardia. (Kawaraguchi Y et al., 2002).
Restrictive cardiomyopathy is defined by restrictive ventricular physiology in the presence of normal or reduced diastolic volumes. It’s important to differentiate it from restrictive pericarditis which is made by endomyocardial biopsy. (Mason JW et O’Connell JB 1999).
The anesthetic goals include Maintenance of the preload, avoidance of decreased myocardial contractility, avoidance of bradycardia & avoidance any increase in pulmonary vascular resistance. (Weller RJ et al., 2002).
Arrhythmognic right ventricular cardiomyopathy is defined as presence of right ventricular dysfunction (global or regional), with or without left ventricular disease and the diagnosis is evident by MRI, rightventricular angiography & biopsy. (Sen-Chowdhry S et al., 2007) .
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Keeping normal sinus rhythm is the only reported strategy in that type of cardiomyopathy through avoidance of arrhythmogenic drugs. Presence of antiarrhythmic drugs , ICD & pacemakers is mandatory. (Fontaine G et al., 2001).
All children with cardiomyopathy should be managed in the ICU postoperatively as they are prone to develop many complication. (Blauwet LA et al., 2010).