Disease Information for Cardiomyopathy: Definition

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; ICD-9CM CODES; 425.4 Other primary cardiomyopathies; 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

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

[Merck Medicus Website Ferri’s Clinical Advisor 2005]

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