Disease Information for Cardiomyopathy, congestive: Definition

  • A syndrome characterized by cardiac enlargement and congestive heart failure. It probably represents the end result of many forms of myocardial damage produced by a variety of toxic, metabolic, or infectious agents; Cardiomyopathies are a group of diseases primarily involving the myocardium and characterized by myocardial dysfunction that is not the result of hypertension, coronary atherosclerosis, valvular dysfunction, or pericardial abnormalities; In dilated cardiomyopathy, the heart is enlarged, and both ventricles are dilated.; Congestive cardiomyopathy; The prevalence of dilated cardiomyopathy in the general adult population is approximately 1%; Incidence increases with age and approaches 10% at age 80 yr; physical findings & clinical presentation: Increased jugular venous pressure; Small pulse pressure; Pulmonary rales, hepatomegaly, peripheral edema ; S3, S4 ; Mitral regurgitation, tricuspid regurgitation (less common) ; etiology: Idiopathic

    Alcoholism (15% to 40% of all cases in Western countries); Collagen-vascular disease (SLE, RA, polyarteritis, dermatomyositis) ; Postmyocarditis; Peripartum (last trimester of pregnancy or 6 mo postpartum); Heredofamilial neuromuscular disease; Toxins (cobalt, lead, phosphorus, carbon monoxide, mercury, doxorubicin, daunorubicin); Nutritional (beriberi, selenium deficiency, carnitine deficiency, thiamine deficiency) ; Cocaine, heroin, organic solvents (“glue-sniffer’s heart”); Irradiation; Acromegaly, osteogenesis imperfecta, myxedema, thyrotoxicosis, diabetes; Hypocalcemia; Antiretroviral agents (zidovudine, didanosine, zalcitabine); Phenothiazines; Infections (viral [HIV], rickettsial, mycobacterial, toxoplasmosis, trichinosis, Chagas’ disease); Hematologic (e.g., sickle cell anemia);Differential diagnosis: Rule-Out Frank pulmonary disease, Valvular dysfunction, Pericardial abnormalities, Coronary atherosclerosis, Psychogenic dyspnea; Studies: Chest x-ray examination, ECG, echocardiogram, medical history with emphasis on the following symptoms: Dyspnea on exertion, orthopnea, PND, Palpitations, Systemic and pulmonary embolism, Cardiac troponin T levels: Persistently elevated troponin T levels are a marker of poor outcome in cardiomyopathy patients; imaging studies include chest x-ray often showing Massive cardiac enlargement, Interstitial pulmonary edema

    ECG: Left ventricular hypertrophy with ST-T wave changes , RBBB or LBBB,;Arrhythmias (atrial fibrillation, PVC, PAC, ventricular tachycardia); ECHOCARDIOGRAM: shows: Low ejection fraction with global akinesia [Cardiomyopathy, Dilated ]

    [Merck Medicus Website Ferri’s Clinical Advisor 2005]