Dilated cardiomyopathy: Difference between revisions
(us in w/u) |
No edit summary |
||
| (25 intermediate revisions by 7 users not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
[[File:Blausen 0165 Cardiomyopathy Dilated.png|thumb|Schematic showing dilated cardiomyopathy compared to a normal heart.]] | |||
[[File:Idiopathic cardiomyopathy, gross pathology 20G0018 lores.jpg|thumb|Dialated cardiomyopathy on pathology. Opened left ventricle of heart shows a thickened, dilated left ventricle with subendocardial fibrosis manifested as increased whiteness of endocardium.]] | |||
*Heart is dilated with poor contraction and EF | |||
== | ===Causes=== | ||
*CHF symptoms | *Idiopathic (25% of [[CHF]]) | ||
*CXR | *Viral/chronic myocarditis (most common identifiable cause) | ||
**Cardiomegaly, | *Other causes | ||
**Ischemic | |||
**Other infectious - [[HIV]], [[Lyme]], [[Chagas]] | |||
**Familial dilated cardiomyopathy | |||
**Hypertensive dilated cardiomyopathy | |||
**Toxic ([[ETOH]]/[[beriberi]], [[cocaine]], [[methamphetamine]], chemo, [[heavy metals]]) | |||
**[[Hyperthyroidism]] | |||
**[[Sarcoidosis]] | |||
**[[Peripartum cardiomyopathy]] | |||
**[[Kawasaki disease]] | |||
**Autoimmune, [[SLE]] | |||
**[[Connective tissue disease]] | |||
**Infiltrative disease | |||
**Mitochondrial disease | |||
**[[Tachycardia]]-mediated | |||
**[[ESRD]] | |||
**Eosinophilic ([[Churg-Strauss syndrome]]) | |||
==Clinical Features== | |||
*[[CHF]] symptoms | |||
==Differential Diagnosis== | |||
{{Cardiomyopathy DDX}} | |||
==Evaluation== | |||
[[File:LBBB+RAD.png|thumb|ECGs of a patient with cardiomyopathy: [[LBBB]] accompanied by right access deviation (about 108°) and left atrial enlargement.]] | |||
[[File:CRT in dilated cardiomyopathy and mitral valve replacement.png|thumb|18 year old with dilated cardiomyopathy (pacemaker in place).]] | |||
[[File:DifCardioMag.png|thumb|Dialated cardiomyopathy on CT.]] | |||
===Workup=== | |||
*[[CXR]] | |||
**Cardiomegaly, pulmonary venous htn | |||
*[[ECG]] | *[[ECG]] | ||
**LV hypertrophy, poor R wave progression | **LV hypertrophy, poor R wave progression | ||
*Ultrasound | *Ultrasound | ||
** Bedside (for gross function) | **[[Cardiac ultrasound|Bedside]] (for gross function) | ||
** TTE/TEE for EF | **TTE/TEE for EF | ||
== | ===Diagnosis=== | ||
*Typically on cardiac ultrasound ([[echo]]) | |||
== | ==Management== | ||
*Treat the underlying disease | |||
*Similar to [[CHF]] exacerbation | *Similar to [[CHF]] exacerbation | ||
*Ensure exacerbation not due to ischemia | *Ensure exacerbation not due to ischemia | ||
==Disposition== | |||
*Admit for new diagnosis | |||
==See Also== | ==See Also== | ||
*[[Cardiomyopathy (Main)]] | *[[Cardiomyopathy (Main)]] | ||
== | ==External Links== | ||
==References== | |||
<references/> | |||
[[Category: | [[Category:Cardiology]] | ||
Latest revision as of 21:16, 11 December 2024
Background
- Heart is dilated with poor contraction and EF
Causes
- Idiopathic (25% of CHF)
- Viral/chronic myocarditis (most common identifiable cause)
- Other causes
- Ischemic
- Other infectious - HIV, Lyme, Chagas
- Familial dilated cardiomyopathy
- Hypertensive dilated cardiomyopathy
- Toxic (ETOH/beriberi, cocaine, methamphetamine, chemo, heavy metals)
- Hyperthyroidism
- Sarcoidosis
- Peripartum cardiomyopathy
- Kawasaki disease
- Autoimmune, SLE
- Connective tissue disease
- Infiltrative disease
- Mitochondrial disease
- Tachycardia-mediated
- ESRD
- Eosinophilic (Churg-Strauss syndrome)
Clinical Features
- CHF symptoms
Differential Diagnosis
Cardiomyopathy
- Dilated cardiomyopathy
- Hypertrophic cardiomyopathy
- Restrictive cardiomyopathy
- Peripartum cardiomyopathy
- Takotsubo cardiomyopathy
- Arrhythmogenic right ventricular dysplasia
Evaluation
ECGs of a patient with cardiomyopathy: LBBB accompanied by right access deviation (about 108°) and left atrial enlargement.
Workup
- CXR
- Cardiomegaly, pulmonary venous htn
- ECG
- LV hypertrophy, poor R wave progression
- Ultrasound
- Bedside (for gross function)
- TTE/TEE for EF
Diagnosis
- Typically on cardiac ultrasound (echo)
Management
- Treat the underlying disease
- Similar to CHF exacerbation
- Ensure exacerbation not due to ischemia
Disposition
- Admit for new diagnosis