Cardiomyopathy
Definition: Heart disease caused by myocardial dysfunction.
Dilated cardiomyopathy
Pathophysiology
- Systolic dysfunction
- Cardiomegaly, dilated chambers, poor contractility
Causes
- Idiopathic
- Familial
- Alcohol
- Peripartum
- Haemochromatosis
- Viral myocarditis
ΔΔx
- Ischaemic heart disease
- Volume overload (valvular lesions or congenital heart disease)
Treatment
As for heart failure.
Hypertrophic cardiomyopathy
= Hypertrophic obstructive cardiomyopathy
= Idiopathic hypertrophic subaortic stenosis
Pathophysiology
- Diastolic dysfunction
- Assymmetric hypertrophy of septum (banana shaped lumen)
- May be outflow tract obstruction
Causes
- Idiopathic
- Familial (autosomal dominant)
- Infants of diabetic mothers
- Storage disease
ΔΔx
- Aortic stenosis
- Hypertensive heart disease
Treatment
Propanolol or verapamil to slow heart rate and allow more time for filling.
The risk is of sudden death from VT. Rx. amiodarone.
Restrictive cardiomyopathy
Pathophysiology
- Diastolic dysfunction
- Non compliant ventricle
Causes
- Idiopathic
- Radiation-induced fibrosis
- Amyloidosis
ΔΔx
- Pericardial constriction