Dilated cardiomyopathy: Difference between revisions
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==Evaluation== | ==Evaluation== | ||
[[File:LBBB+RAD.png|thumb|ECGs of a patient with cardiomyopathy: [[LBBB]] accompanied by | [[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: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.]] | [[File:DifCardioMag.png|thumb|Dialated cardiomyopathy on CT.]] | ||
===Workup=== | ===Workup=== | ||
*[[CXR]] | *[[CXR]] | ||
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===Diagnosis=== | ===Diagnosis=== | ||
*Typically on cardiac ultrasound (echo) | *Typically on cardiac ultrasound ([[echo]]) | ||
==Management== | ==Management== | ||
*Treat the underlying | *Treat the underlying disease | ||
*Similar to [[CHF]] exacerbation | *Similar to [[CHF]] exacerbation | ||
*Ensure exacerbation not due to ischemia | *Ensure exacerbation not due to ischemia | ||
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