What is Global Hypokinesis?

Global hypokinesis is a term used to describe a condition marked by generalized weakness of the heart and mild to extreme obstructions in the coronary blood vessels. Every section of the heart, including the cardiac walls, ventricles, arteries, and membranes, etc. function irregularly and elicit weakness or loss of strength. Global hypokinesis is different from regional weakness of the heart, as the latter features weakness of only some sections of the heart while other sections tend to function just fine.

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Global hypokinesis occurs due to heart attack, ischemic cardiac disease, and cardiomyopathy, etc. which may be caused due to some pre-existing inherited conditions. Consult a doctor to discuss and understand the test results and a diagnosis of global hypokinesis.

Global hypokinesis and heart failure

Reduced cardiac output which occurs as part of global hypokinesis anomalies can trigger the onset of cardiac failure, congestive heart failure, and other cardiac problems.

Cardiac failure does not mean nil cardiac functioning; it only means that the heart is unable to pump blood efficiently or normally, leading to increased pressure on the heart and decreased blood supply to varied organs and tissues of the body. This may then lead to decreased flow of oxygen and varied nutrients to different parts of the body. The heart may respond to all these problems by thickening, stiffening, or stretching the cardiac chambers so that they can hold additional quantities of blood and then pump it to different areas of the body. Chronic cardiac failure may eventually progress into congestive heart failure.

Symptoms

Heart failure associated global hypokinesis may be identified by the below listed signs and symptoms:

  • Congestion of the lungs: There may be accumulation of fluids in the lungs. Affected individuals may suffer from shortness of breath during workouts and exercising; respiration difficulties when resting or lying flat; and/or a dry hacking cough or wheezing.
  • Rapid or irregular heartbeat: The heart tends to beat faster so as to pump adequate amounts of blood to different areas of the body. This can cause fast or abnormal heartbeat.
  • Retention of water or fluids: Reduced blood supply to the kidneys due to global hypokinesis can trigger a case of water retention. This can result in edema, weight gain, bloating, nausea, loss of appetite, and frequent urination during nighttime.
  • Dizziness, weakness, and fatigue: Reduced flow of blood to the brain can cause dizziness, confusion, and disorientation. Similarly, decreased flow of blood to the muscles and vital tissues and organs can lead to fatigue, lethargy, and weakness.

Causes of global hypokinesis  

Global hypokinesis and subsequent case of heart failure is caused due to the occurrence of a variety of cardiac ailments that cause cardiac dysfunction as well as some kind of damage to the muscles of the heart. Some of these common causative cardiac conditions are discussed below:

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  • Overload of the cardiac system:  The presence of different medical conditions such as hypertension, thyroid disorders, valve abnormalities, congenital heart defects, kidney ailments, and diabetes, etc., can result in increased pressure on the heart to work harder. Such excessive workload on the cardiac system can trigger a case of global hypokinesis related heart failure. Patients who suffer from many such disorders concurrently are more likely and at increased risk to experience such cardiac anomalies.
  • CAD/Coronary Artery Disease: In this, the arteries that provide blood and oxygen to the cardiac system may be adversely affected leading to low levels of oxygen-rich blood supply to the heart muscles. Severe constriction or obstructions in the arteries can also prevent the flow of vital nutrients to the heart, thereby damaging it and causing global hypokinesis associated heart failure.
  • Heart attack: A cardiac arrest may be caused due to blockages in a coronary artery. Such clogging may occur abruptly and stop the flow of blood to the muscles of the heart, thereby damaging it. Some parts of the cardiac muscle system, or sometimes all parts, may not get adequate amounts of oxygen-rich blood. Such parts of the heart may then develop scarring resulting in its dysfunction.
  • Cardiomyopathy: In this condition, damage to the heart occurs due to varied causes that do not include problems in the arteries or blood supply, different types of infections, alcoholism, or drug abuse.

Treatment  

Global hypokinesis and a subsequent case of heart failure is treated via monitored intake of different medicines, consumption of a healthy and balanced diet, and lifestyle changes. Doctors may opt for advanced specialized medical therapies to remedy severe cases of global hypokinesis.

Treatment of global hypokinesis occurs in 4 phases as listed below:

  • Stage 1: Patients suffering from mild cases of global hypokinesis and/or carrying a high risk to development of cardiac failure are included. Patients with a variety of underlying disorders such as high blood pressure, coronary artery disease, diabetes, and metabolic syndrome as well as those with a family history of cardiomyopathy and/or a personal history of cardio-toxic drug therapy, alcohol abuse, and rheumatic fever are also included in this group.
    • Treatment involves rehab for alcoholism and drug abuse, quitting smoking, medications and therapy for hypertension and lipid problems, and regular exercising. Doctors may also prescribe drugs such as ACE inhibitors, beta blockers, and/or ARB.
    • Stage 2: Individuals with a personal history of heart attack, valve conditions, and cardiomyopathy as well as systolic left ventricular abnormalities without any symptoms of cardiac failure are included in this group.
      • Along with treatments mentioned in Stage 1, a health care provider may also prescribe aldosterone inhibitor medicines as well as replacement or repair of damaged valves or arteries via surgery.
      • Stage 3: People with systolic cardiac failure accompanied by symptoms like reduced strength during workouts, breathlessness, and exhaustion or fatigue are included.
        • Stage 1 treatment options along with other therapies like use of prescription aldosterone inhibitors; combination of hydralazine and nitrate for African-Americans experiencing chronic symptoms; diuretics and digoxin for persistent symptoms; regulation of weight; use of biventricular pacemaker, cardiac resynchronization therapy, and/or ICD; stopping the use of medications that worsen global hypokinesis and accompanying heart failure; and limiting the consumption of salt and fluids.
        • Stage 4: It includes patients with systolic cardiac failure that continues with severe symptoms even after advanced medical therapies have been administered.
          • Along with stages 1, 2, and 3 treatment options, patients may be treated via continuous IV inotropic drugs, ventricular assist devices, alternative therapies, heart transplant and/or other surgeries, and care at a hospice.
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