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Niemann J. Niemann, James T. Cardiomyopathies and Pericardial Disease. Tintinalli J. Judith E. Tintinalli, et al. Accessed December 02, Download citation file: RIS Zotero. Reference Manager. Autosuggest Results. Expand All Sections. View Table Favorite Table Download. Sign In. Username Error: Please enter User Name. Password Error: Please enter Password. Best Value. View All Subscription Options. Pop-up div Successfully Displayed This div only appears when the trigger link is hovered over.
Congestive heart failure Chest pain Regurgitant murmurs. Cardiac imaging may reveal right ventricular abnormalities, including aneurysms, segmental dilation, and reduced ejection fraction. These abnormalities lead to left ventricle dysfunction and, ultimately, to heart failure, arrhythmias, thromboembolic disease, and sudden cardiac death. Dilated cardiomyopathy DCM has a prevalence of , and is the leading indication for heart transplantation. Chemotherapeutic agents anthracyclines, cyclophosphamide, doxorubicin [Adriamycin]. Information from references 1 and 3.
DCM can occur at any age, but is most common in patients 40 to 59 years of age. Most patients are symptomatic at the time of diagnosis, but asymptomatic patients may be identified through screening of family members of affected patients.
ACE inhibitors and ARBs have been shown to provide significant mortality benefit in patients with heart failure with reduced ejection fraction. The pattern of impaired ventricular filling with normal systolic function is typical, resulting from increased myocardial stiffness. Restrictive cardiomyopathy may present with signs of right-sided heart failure, such as ascites or peripheral edema. Examination may reveal elevated jugular venous pressure before the development of pulmonary edema. Chest radiography can detect pulmonary vascular congestion with a normal cardiac silhouette.
Symptomatic interventions include control of volume overload with diuretics or aldosterone antagonists and evaluation for atrioventricular block, with pacemaker insertion as indicated. Peripartum cardiomyopathy is defined as left ventricular systolic dysfunction at the end of pregnancy or in the months following delivery. Symptoms such as fatigue, edema, and dyspnea on exertion can be confused with more common pregnancy complications such as preeclampsia, and diagnosis of cardiomyopathy may be delayed. Common echocardiography findings include left ventricular dilation, left ventricular systolic dysfunction, and pulmonary hypertension.
Therefore, ACE inhibitors and ARBs should be avoided in pregnant patients, and physicians should take care to avoid hypotension and reduced uterine perfusion when using diuretic therapy. Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or broken-heart syndrome, is defined as an abrupt onset of left ventricular dysfunction in response to severe emotional or physiologic stress. The exact prevalence is difficult to determine but has been estimated at 0. A unique pattern of apical ballooning of the left ventricle is usually exhibited on echocardiography.
Laboratory abnormalities may include elevated cardiac enzymes.source site
Cardiomyopathy: An Overview - American Family Physician
Acute complications, such as shock or heart failure, should be managed appropriately. Heart muscle disease resulting from an extracardiovascular cause is known as secondary cardiomyopathy. Although some etiologies are associated with specific disease patterns e. Secondary causes can be grouped into several categories including endocrine, infectious, toxic, autoimmune, nutritional, and neuromuscular Table 2 1 , 3.
Evaluation and management are aimed primarily at the underlying disease process, removing offending agents, and treatment of the symptoms of heart failure. An autosomal dominant pattern of inheritance in HCM has been recognized for decades.
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Researchers identified mutations in genes coding for sarcomere proteins. Since then, more than 1, mutations among 13 genes have been identified as causing a heterogeneous phenotypic expression and course of illness. Patients with more than one mutation have an earlier onset of disease and a more severe course of illness. Because of the preponderance of genetic influences on cardiomyopathy, it is generally recommended that patients with any cardiomyopathy be referred for genetic counseling, especially if the treating physician is not familiar with current guidelines.
Clinical screening may include complete history and physical examination, electrocardiography, and echocardiography. Guidelines regarding optimal screening intervals and referral to genetic counseling are emerging. HCM is the most common cause of sudden cardiac death in athletes, accounting for about one-third of cases. This devastating complication is more prevalent in male athletes and nonwhites.
The European Society of Cardiology suggests full restrictions, whereas the United States 36th Bethesda Conference guidelines find insufficient evidence to exclude these persons from competitive sports. Data Sources : We searched the Cochrane Database of Systematic Reviews, PubMed, Clinical Key, National Guideline Clearinghouse, Dynamed, and Essential Evidence using the key words cardiomyopathy, hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy, heart failure, and congestive heart failure. Some sources were revisited. Search dates: March, June, and July and July Already a member or subscriber?
Log in. Louis, Mo. Louis, MO e-mail: brielerj slu. Reprints are not available from the authors. Eur Heart J. Dilated cardiomyopathy: a review. J Clin Pathol. Nihoyannopoulos P, Dawson D. Restrictive cardiomyopathies. Eur J Echocardiogr. J Am Coll Cardiol. Misconceptions and facts about hypertrophic cardiomyopathy. Am J Med. Genetic basis of hypertrophic cardiomyopathy: from bench to the clinics.
Complete Medical Guide and Prevention for Heart Disease : Volume IX; Cardiomyopathy
J Cardiovasc Electrophysiol. Diagnostic, prognostic, and therapeutic implications of genetic testing for hypertrophic cardiomyopathy. The management of hypertrophic cardiomyopathy. N Engl J Med. Management of symptoms in hypertrophic cardiomyopathy. Presse Med. Pharmacological treatment of hypertrophic cardiomyopathy: current practice and novel perspectives.
Eur J Heart Fail. Current effectiveness and risks of isolated septal myectomy for hypertrophic obstructive cardiomyopathy. Ann Thorac Surg.