Cardi Omega ly

Cardi Omega ly
Cardi Omega ly on chestX-raywith apacemaker
Specialty	Cardiology
Types	Athletic heart syndrome,Ventricular hypertrophy,Atrial enlargement
Causes	Dilated cardiomyopathy,Hypertrophic cardiomyopathy.
Diagnostic method	Hypertrophic cardiomyopathy screening

Cardi Omega ly(sometimesmegacardiaormegalocardia) is a medical condition in which theheartbecomes enlarged. It is more commonly referred to simply as "having anenlarged heart".It is usually the result of underlying conditions that make the heart work harder, such asobesity,heart valve disease,high blood pressure (hypertension), andcoronary artery disease.Cardiomyopathyis also associated with cardi Omega ly.

Cardi Omega ly can be serious and can result incongestive heart failure.Recent studies suggest that cardi Omega ly is associated with a higher risk ofsudden cardiac death.

Cardi Omega ly may diminish over time, but many people with an enlarged heart (dilated cardiomyopathy) need lifelong medication.Having a family history of cardi Omega ly may indicate an increased risk for this condition.

Lifestyle factors that can help prevent cardi Omega ly include eating a healthy diet, controlling blood pressure, exercise, medications, and not abusing anabolic-androgenic steroids, alcohol andcocaine.

Signs and symptoms

Further information:Cardiogenic shock

For many people, cardi Omega ly isasymptomatic.For others, if the enlarged heart begins to affect the body's ability to pump blood, then symptoms associated with congestive heart failure may arise, including:

• Heartpalpitations– the irregular beating of the heart, usually associated with a valve
• Severe shortness of breath (especially when physically active)
• Chest pain
• Coughing, when lying down
• Fatigue
• Leg swelling
• Increasedabdominal girth
• Weight gain
• Edema– swelling
• Fainting

Causes

The causes of cardi Omega ly are not well understood and many cases have no known cause. Lifestyle-related risk factors include tobacco use and highcholesterol,high blood pressure, anddiabetes.Non-lifestyle risk factors include a family history of cardi Omega ly,coronary artery disease(CAD), congenital heart failure,atheroscleroticdisease,valvular heart disease,exposure to cardiac toxins, sleep-disordered breathing (such assleep apnea), sustained cardiacarrhythmias,abnormalelectrocardiograms,and cardi Omega ly on chest X-ray.

Research and the evidence of previous cases link the following (below) as possible causes of cardi Omega ly.

The most common causes of cardi Omega ly arecongenital(patients are born with the condition based on a genetic inheritance), high blood pressure (which can enlarge the leftventriclecausing the heart muscle to weaken over time), and coronary artery disease. In the latter case, the disease creates blockages in the heart's blood supply, leading to tissue death which causes other areas of the heart to work harder, causing the heart to expand in size.

Other possible causes include:

• Heart valve disease
• Cardiomyopathy (disease of the heart muscle)
• Pulmonaryhypertension
• Pericardialeffusion(fluid around the heart)
• ThyroidDisorders
• Hemochromatosis(excessive iron in the blood)
• Amyloidosis
• Chagas disease,an important cause of cardi Omega ly inLatin America
• Viral infection of the heart
• Pregnancy, with enlarged heart developing around the time of delivery (peripartum cardiomyopathy)
• Kidney disease requiring dialysis
• Alcohol or cocaine abuse
• HIV infection
• Diabetes

In recent years, a consistent theme has occurred in rock and metal drummers dying of drug overdoses and later revealed via autopsy that they were suffering from Cardi Omega ly, which may have been worsened by a mix of drug use and the toll such physical exercise takes on the heart, examples of such cases includeJimmy ‘The Rev’ Sullivan(Avenged Sevenfold) andTaylor Hawkins(Foo Fighters).

Mechanism

Within the heart, the working fibers of themyocardialtissue increase in size. As the heart works harder theactinandmyosinfilaments experience less overlap which increases the size of the myocardial fibers. If there is less overlap of the protein filaments within thesarcomeresof the muscle fibers, they will not be able to effectively pull on one another. If the heart tissue gets too big and stretches too far, then those filaments cannot effectively pull on one another to shorten the muscle fibers, impacting the heart's sliding filament mechanism. If fibers cannot shorten properly and the heart cannot contract properly, then blood cannot be effectively pumped to the lungs to be re-oxygenated or to the body to deliver oxygen to the working tissues of the body.

An enlarged heart is more susceptible to forming blood clots in the heart lining. These clots can form elsewhere in the body, potentially disrupting blood supply to other organs.

Diagnosis

Many techniques and tests are used to diagnose an enlarged heart. These tests can be used to see how efficiently the heart is pumping, determine which chambers of the heart are enlarged, look for evidence of prior heart attacks and determine if a person has congenital heart disease.

Cardiothoracic ratio =${MRD+MLD \over ID}$
where:
MRD = greatest perpendicular diameter from midline to right heart border
MLD = greatest perpendicular diameter from midline to left heart border
ID = internal diameter of chest at level of right hemidiaphragm

• Chest X-ray:X-rayimages help to visualize the condition of the lungs and heart. If the heart is enlarged on an X-ray, other tests will usually be needed to find the cause. A useful measurement on X-ray is the cardio-thoracic ratio, which is thetransverse diameterof the heart, compared with that of thethoracic cage.These diameters are taken fromPA chest x-raysusing the widest point of the chest and measuring as far as the lungpleura,rather than lateral skin margins. If the ratio is greater than 50%, pathology is suspected.The measurement was first proposed in 1919 to screen military recruits. A newer approach to using these x-rays for evaluating heart health takes the ratio of heart area to chest area and has been called the two-dimensional cardiothoracic ratio.
• Electrocardiogram:This test records the electrical activity of the heart through electrodes attached to the skin. Impulses are recorded as waves and displayed on a monitor or printed on paper. This test helps diagnose heart rhythm problems and assess the damage to a person's heart from a heart attack.
• Echocardiogram:This test uses sound waves to produce a video image of the heart. With this test, the four chambers of the heart can be evaluated.
• Stress test:A stress test, also called an exercise stress test, provides information about how well the heart works during physical activity. It usually involves walking on a treadmill or riding a stationary bike while heart rhythm, blood pressure, and breathing are monitored.
• Cardiac computerized tomography(CT) ormagnetic resonance imaging(MRI). These techniques create images of the heart for inspection.
• Blood tests:Blood tests may be ordered to check the levels of substances in the blood that may show a heart problem. Blood tests can also help rule out other conditions.

Histopathology of (a) normal myocardium and (b) myocardial hypertrophy. Scale bar indicates 50 μm.

Weight of the heart versus the body

• Cardiac catheterizationand biopsy:In this procedure, a catheter is inserted into the groin and threaded through the blood vessels to the heart, where a biopsy of the heart can be extracted for laboratory analysis.
• Autopsy:Cardi Omega ly is indicated if the heart weighs more than >399 grams in women and >449 grams in men.

Classification

Cardi Omega ly can be classified by the main enlarged location of the heart, and/or by the structure of the enlargement.

Specific subtypes includeathletic heart syndrome,which is a non-pathologicalcondition commonly seen insports medicinein which the heart is enlarged, and the restingheart rateislowerthan normal.

By enlarged location

• Ventricular hypertrophy
  • Left
  • Right/Cor pulmonale
• Atrial enlargement
  • Left
  • Right

Structure of enlargement

Dilated cardiomyopathyis the most common type of cardi Omega ly. In this condition, the walls of the left and/or right ventricles of the heart become thin and stretched.

In the other types, the heart's left ventricle becomes abnormally thick. Hypertrophy is usually what causes left ventricular enlargement.Hypertrophic cardiomyopathyis typically an inherited condition.

Treatment

Treatments include a combination of medications and medical/surgical procedures. Below are some of the treatment options:

Medications

• Diuretics:to lower the amount of sodium and water in the body, which can help lower the pressure in the arteries and heart.
• Angiotensin-converting enzyme (ACE) inhibitors:to lower blood pressure and improve pumping ability.
• Angiotensin receptor blockers(ARBs): to provide the benefits of ACE inhibitors for patients with ACE inhibitor issues.
• Beta blockers:to lower blood pressure and improve heart function.
• Digoxin:to help improve heart pumping function and lessen the need for hospitalization for heart failure.
• Anticoagulants:to reduce blood clot risk.
• Anti-arrhythmics:to maintain normal heart rhythm.

Devices to regulate heartbeat

• Pacemaker:Coordinates contractions between ventricles. In people at risk ofarrhythmias,drug therapy or animplantable cardioverter-defibrillator(ICD).
• ICDs: Small devices implanted in the chest to monitor heart rhythm and deliver electrical shocks to control abnormal heartbeats. The devices can also work as pacemakers.

Surgical procedures

• Valve surgery: If an enlarged heart is caused by a problem with a heart valve, surgery can remove the valve and replace it with either an artificial valve or a tissue valve from a pig, cow or deceased human donor. If blood leaks backward through a valve (valve regurgitation), the leaky valve may be surgically repaired or replaced.
• Coronary bypass surgery:to address coronary artery disease, which can lead to an enlarged heart.
• Left ventricular assist device:(LVAD): to help a weak heart pump, potentially while waiting for a heart transplant or as a long-term treatment for heart failure.
• Heart transplant:to provide a final option after other treatments fail.

Consequences

The exact mortality rate for people with cardi Omega ly is unknown. However, many people live for a long time with an enlarged heart and, if detected early, treatment can help improve the condition and prolong their lives.

• Heart failure: One of the most serious types of enlarged heart, an enlarged left ventricle, increases the risk of heart failure. In heart failure, the heart muscle weakens, and the ventricles stretch (dilate) to the point that the heart can't pump blood efficiently throughout the body.
• Blood clots: If clots enter the bloodstream, they can block blood flow to vital organs, possibly causing a heart attack or stroke. Clots that develop on the right side of the heart may travel to the lungs, a dangerous condition called apulmonary embolism.
• Heart murmur:Two of the heart's four valves – themitralandtricuspid valves– may become dilated and not close properly, leading to a backflow of blood. This flow creates sounds calledheart murmurs.
• Cardi Omega ly may be a temporary condition that can resolve on its own.

Recommended lifestyle changes

• Smoking cessation
• Limiting alcohol and caffeine intake
• Maintaining a healthy weight
• Increasing fruits and vegetables in a daily diet
• Limiting consumption of high-fat and/or high-sugar foods
• Getting adequate restful sleep

Further reading

• Amin, Hina; Siddiqui, Waqas J. (2019)."Cardi Omega ly".StatPearls.StatPearls Publishing.PMID31194436.
• Ampanozi, Garyfalia; Krinke, Eileen; Laberke, Patrick; Schweitzer, Wolf; Thali, Michael J.; Ebert, Lars C. (1 September 2018). "Comparing fist size to heart size is not a viable technique to assess cardi Omega ly".Cardiovascular Pathology.36:1–5.doi:10.1016/j.carpath.2018.04.009.PMID29859507.S2CID44086023.
• Agostoni, PierGiuseppe; Cattadori, Gaia; Guazzi, Marco; Palermo, Pietro; Bussotti, Maurizio; Marenzi, Giancarlo (1 November 2000). "Cardi Omega ly as a possible cause of lung dysfunction in patients with heart failure".American Heart Journal.140(5): A17–A21.doi:10.1067/mhj.2000.110282.PMID11054632.
• Luedde, Mark; Katus, Hugo; Frey, Norbert (1 January 2006). "Novel Molecular Targets in the Treatment of Cardiac Hypertrophy".Recent Patents on Cardiovascular Drug Discovery.1(1): 1–20.doi:10.2174/157489006775244290.PMID18221071.

External links

• American Heart Association