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Dilated Cardiomyopathy

WHAT YOU SHOULD KNOW:

Dilated Cardiomyopathy (Inpatient Care) Care Guide

Dilated cardiomyopathy (DCM) is a disease of the heart muscle that causes the ventricles to get larger and weaker. The ventricles are the 2 lower chambers of your heart. They pump blood to your lungs and the rest of your body. When the ventricles are dilated and weak, your heart cannot pump blood well. This decreases the blood and oxygen supply to the rest of your body.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

You may bleed more than expected or get an infection after surgery. Without treatment your heart may get weaker and your symptoms may get worse. You may have abnormal heartbeats, trouble breathing, or get a blood clot. The clot may travel to your heart or brain and cause a heart attack or stroke. Fluid may build up in your lungs and body. This may make it hard for you to breathe. Your liver and kidneys may fail. These problems can be life-threatening.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

Monitoring:

  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

  • Pulmonary artery catheter: This is a balloon-tipped catheter (thin tube) inserted through a vein in your neck or groin. The pulmonary artery (PA) catheter goes into the right side of your heart and continues to your pulmonary artery. The balloon is inflated to wedge the catheter in place. The PA catheter has a device in it that measures the pressure in your heart and lungs. The catheter is attached to a monitor that shows the pressure measurements. The measurements can also show caregivers how your heart responds to certain heart medicines.

  • Intake and output: Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.

  • Weight: You may be weighed each day. Caregivers compare your weight from day to day to record how much body fluid you have. You can become dehydrated if you lose too much. You can have shortness of breath or swelling in your legs if you retain too much.

Tests:

  • Blood gases: This is also called an arterial blood gas, or ABG. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. Your blood is tested for the amount of oxygen and carbon dioxide in it. The results can tell caregivers how well your lungs are working.

  • Blood tests: A sample of your blood may be sent to the lab for tests. These tests tell if your organs, such as your liver and kidneys, are working correctly.

  • Chest x-ray: This is used to check the size of your heart and look for fluid around your heart and lungs.

  • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart.

  • Cardiac catheterization: This is a procedure done to find the cause of and treat a heart condition. A thin, bendable tube inserted into an arm, neck, or groin vein is moved into your heart. Your caregiver may use an x-ray to guide the tube to the right place. Dye (contrast) may be put into your vein so the pictures show up better on a monitor.

  • Tissue biopsies: During this test, a small sample of tissue is taken from your heart to help find the cause of DCM. It can also be used to check for damage caused by DCM.

Medicines:

  • Diuretics: This medicine helps decrease fluid around your lungs and heart. It also helps decrease extra fluid in your legs and ankles. You will urinate more often when you take diuretics.

  • Blood thinners: Blood thinners help prevent blood clots.

  • Heart medicine: This medicine helps strengthen or regulate your heartbeat.

  • Blood pressure medicine: This is given to lower your blood pressure. A controlled blood pressure helps protect your organs, such as your heart, lungs, brain, and kidneys. Take your blood pressure medicine exactly as directed.

Treatment:

  • Pacemaker: This device is placed under your skin to help regulate your heartbeats.

  • Implantable cardiac defibrillator: A cardiac defibrillator is placed under your skin to help prevent life-threatening arrhythmias (abnormal heartbeats).

  • Left ventricle assist device (LVAD): This device is placed under your skin to help your heart pump better. You may need an LVAD while you are waiting for a heart transplant.

  • Heart valve surgery: You may need to have a heart valve repaired or replaced so your heart can pump enough blood to your body. Heart valves allow blood flow between the chambers of your heart.

  • Heart transplant: During a heart transplant, your diseased heart is removed and replaced with a donor heart.

Activity:

  • You may need to rest in bed. Ask your caregivers if you may exercise your legs in bed. Do this by lifting one leg off the bed and drawing big circles with your toes. Repeat with the other leg. Another good exercise is to lie on your side and pretend to pedal a bike. This may help your legs become stronger and it may stop blood clots from forming. Stop exercising if you become tired.

  • Your caregiver will tell you when it is okay to get out of bed. Call your caregiver before you get up for the first time. If you ever feel weak or dizzy, sit or lie down right away.

Pneumatic boots:

Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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