|
Diagnostic Problems of Dilated Cardiomyopathy |
K. Nadaraia
|
The
aim of our work was to study the cases of the lack of Dilated
Cardiomyopathy (DCM) diagnostic and evaluate the quality and frequency of
detection of poor prognosis predictors of DCM in primary diagnostic.
We
studied 75 patients with Dilated Cardiomyopathy. (61 men, 14 women, mean
age 42,5 years, range 18-67). All standard examination, including 24-hours
ECG Holter monitoring, Doppler-echocardiography, treadmill test, were
performed.
Out
of 75 cases of DCM the condition previously was diagnosed only in 6(8%)
cases, in 24(32%) cases it was the first visit to a physician and in
45(60%) cases there were other diagnoses in the history: Coronary heart
diseases (19 cases), Mitral valvular diseases (9), Myocardities (4),
Corpulmonale (3), Pneumonia (2), Constrictive Pericardities (1),
Abstein’s Anomaly (1), in 6 cases final diagnosis could not be made. In
69 patients in whom we were primarily diagnosed DCM, was revealed a high
frequency of poor prognosis predictors: Heart Failure
III-IVf.c. (NYHA) – 57(82,6%) cases, Ejection Fraction<30% -
28(40,6%), Mitral-Septal Separation>2,5cm – 42(60,9%), Left
Ventricular End-diastolic Diameter>7cm – 44(63,8%), Thromboembolies
– 22(31,9%), Ventricular arrhythmia – 63(91,3%), Left Bundle Branch
Block – 25(36,2%), Atrial fibrillation – 24(34.8%).
We
confirm, that Most of patients (60%) with DCM were undergone the
inadequate treatment under different diagnosis through a long time. DCM
was diagnosed only when most predictors of poor prognosis were already
present and frequency of the revealing was substantially high.
|
| Literature: |
|
1.
Kipshidze N.N., Rogava M.A. 4th World Congress on Heart Feilure –
Mechanisms and Managment. // Jerusalem, Israel, May 26-29, 1996. 2. Naoki Matsuda, Hiroshi Kasanuki. Prognosis and treatment of Cardiomiopathies and Myocarditis. // 1994. P.163-167. Tokyo. 3. Амосова Е.Н. // Тер.Архив, 1990, Т.62, №8, с.86-90. 4. Mitsuyasu Terashima, Yoshiyuki Yokota. Prognosis and treatment of Cardiomiopathies and Myocarditis. // 1994. P.149-155. Tokyo. 5. Кипшидзе Н.Н., Чумбуридзе В.Б. Кардиомиопатии. // 1990. 6. Ì. ÒÏÂÀÅÀ, È. ÈÀÅáÄËÉÞÄ, À. àÏËÀÞÄ. ÈÄÒÀÐÉÉÓ ÀØÔÖÀËÖÒÉ ÐÒÏÁËÄÌÄÁÉ, 1992, ÂÅ.91-93.
|
| Contents |