Dilated cardiomyopathy

Background

• Heart is dilated with poor contraction and EF
• Idiopathic form accounts for 25% of CHF
• Viral/chronic myocarditis is most common identifiable causes
• Other causes
  • Ischemic
  • Other infectious - HIV, Lyme, Chagas
  • Familial dilated cardiomyopathy
  • Hypertensive dilated cardiomyopathy
  • Toxic (EtOH/beriberi, cocaine, meth, chemo, heavy metals)
  • Hyperthyroidism
  • Sarcoidosis
  • Peripartum cardiomyopathy
  • Kawasaki disease
  • Autoimmune, SLE
  • Connective tissue disease
  • Infiltrative disease
  • Mitochondrial disease
  • Tachycardia-mediated
  • ESRD
  • Eosinophilic (Churg Strauss)

Evaluation

• CHF symptoms
• CXR
  • Cardiomegaly, pulmonary venous htn
• ECG
  • LV hypertrophy, poor R wave progression
• Ultrasound
  • Bedside (for gross function)
  • TTE/TEE for EF

Differential Diagnosis

Cardiomyopathy

• Dilated cardiomyopathy
• Hypertrophic cardiomyopathy
• Restrictive cardiomyopathy
• Peripartum cardiomyopathy
• Takotsubo cardiomyopathy
• Arrhythmogenic right ventricular dysplasia

Management

• Treat the underlying diseae
• Similar to CHF exacerbation
• Ensure exacerbation not due to ischemia

See Also

• Cardiomyopathy (Main)