Dilated cardiomyopathy: Difference between revisions
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==Background== | ==Background== | ||
*Idiopathic | [[File:Blausen 0165 Cardiomyopathy Dilated.png|thumb|Schematic showing dilated cardiomyopathy compared to a normal heart.]] | ||
*Viral/chronic myocarditis | [[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=== | |||
*Idiopathic (25% of [[CHF]]) | |||
*Viral/chronic myocarditis (most common identifiable cause) | |||
*Other causes | *Other causes | ||
**Ischemic | **Ischemic | ||
**Other infectious - [[HIV]], [[Lyme]], [[Chagas]] | |||
**Familial dilated cardiomyopathy | **Familial dilated cardiomyopathy | ||
** | **Hypertensive dilated cardiomyopathy | ||
**Toxic ( | **Toxic ([[ETOH]]/[[beriberi]], [[cocaine]], [[methamphetamine]], chemo, [[heavy metals]]) | ||
**[[Hyperthyroidism]] | **[[Hyperthyroidism]] | ||
**Autoimmune, SLE | **[[Sarcoidosis]] | ||
**Connective tissue disease | **[[Peripartum cardiomyopathy]] | ||
**[[Kawasaki disease]] | |||
**Autoimmune, [[SLE]] | |||
**[[Connective tissue disease]] | |||
**Infiltrative disease | **Infiltrative disease | ||
**Mitochondrial disease | **Mitochondrial disease | ||
**Tachycardia-mediated | **[[Tachycardia]]-mediated | ||
**ESRD | **[[ESRD]] | ||
**Eosinophilic ([[Churg-Strauss syndrome]]) | |||
==Clinical Features== | |||
*[[CHF]] symptoms | |||
==Diagnosis== | ==Differential Diagnosis== | ||
{{Cardiomyopathy DDX}} | |||
*CXR | |||
**Cardiomegaly, | ==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 | ||
** [[ | **[[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