CARDIOMYOPATHY

LEONARD SHAJU
JOISY ALOOR
Cardiomyopathy refers to diseases of the heart
muscle.
In cardiomyopathy, the heart muscle becomes
enlarged, thick, or rigid. In rare cases, the muscle
tissue in the heart is replaced with scar tissue.
 CLASSIFICATION

According to the WHO types of cardiomyopathy are:

Hypertrophic cardiomyopathy
Dilated cardiomyopathy
Restrictive cardiomyopathy
Arrhythmogenic right ventricular dysplasia
Unclassified cardiomyopathy
 HYPERTROPHIC C.M

Hypertrophic cardiomyopathy is very common and

can affect people of any age. Hypertrophic
cardiomyopathy affects men and women equally, and
about 1 out of every 500 people has the disease.

Hypertrophic cardiomyopathy happens when the
heart muscle enlarges and thickens without an
obvious cause. Usually the ventricles, the lower
chambers of the heart, and septum (the wall that
separates the left and right side of the heart) thicken.
 DILATED C.M

Dilated cardiomyopathy develops when the

ventricles enlarge and weaken.
The weakened chambers of the heart don’t pump
effectively, causing the heart muscle to work harder.
Over time, the heart loses the ability to pump blood
effectively.
Dilated cardiomyopathy can lead to heart
failure, heart valve disease, irregular heart rate, and
blood clots in the heart.
 RESTRICTIVE C.M

Restrictive cardiomyopathy develops when the

ventricles become stiff and rigid but the walls of the
heart do not thicken.
 As a result, the ventricles do not relax and don’t fill
with the normal blood volume. As the disease
progresses, the ventricles do not pump as well and
the heart muscle weakens. 
ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA

Arrhythmogenic right ventricular dysplasia is a rare

type of cardiomyopathy that occurs when the muscle
tissue in the right ventricle is replaced with fatty or
fibrous tissue.
This can lead to disruptions in the heart’s electrical
signals and causes arrhythmias.
 UNCLASSIFIED C.M

Left ventricular noncompaction happens when the

left ventricle has trabeculations, projections of
muscle inside the ventricle.
Takotsubo cardiomyopathy, or broken heart
syndrome, happens when extreme stress leads to
heart muscle failure. Though rare, this condition is
more common in post-menopausal women.
FETAL CM
 HCM CAUSES

Hypertrophic cardiomyopathy usually is inherited.

It’s caused by a mutation or change in some of the
genes in heart muscle proteins.
Hypertrophic cardiomyopathy also can develop over
time because of high blood pressure, aging, or other
diseases, such as diabetes or thyroid disease.
 DCM CAUSES

Alcohol, especially if you also have a poor diet

Certain toxins, such as poisons and heavy metals
Complications during the last months of pregnancy
Ischemic heart disease, heart attack, high blood
pressure, diabetes, thyroid disease, viral hepatitis,
and HIV
Illegal drugs, such as cocaine and amphetamines,
and some medicines used to treat cancer
Infections, especially viral infections that inflame the
heart muscle
 RCM CAUSES

Amyloidosis
Connective tissue disorders
Hemochromatosis
Sarcoidosis
Some cancer treatments, such as radiation and
chemotherapy.
 MAJOR RISK FACTORS

A family history of cardiomyopathy, heart failure,

or sudden cardiac arrest (SCA).
A disease or condition that can lead to cardiomyopathy,
such as ischemic heart disease, heart attack, or a viral
infection that inflames the heart muscle.
Diabetes or other metabolic diseases, or severe obesity
Diseases that can damage the heart, such
as hemochromatosis, sarcoidosis, or amyloidosis.
Long-term alcoholism.
Long-term high blood pressure.
DIAGNOSTIC SIGNS
It’s important to identify those who may be at
high risk for cardiomyopathy.
After all, some people with cardiomyopathy
never have signs or symptoms.
Others don’t have signs or symptoms in the
early stages of the disease.
If people without symptoms recognize their
heightened risk for cardiomyopathy, there’s a better
chance of diagnosing it early, when treatment may
be most effective.
Signs and symptoms of heart failure usually occur in
the later stages of cardiomyopathy, as the heart
weakens.
Signs and symptoms of cardiomyopathy include:
1. Shortness of breath or trouble breathing, especially
with physical exertion
2. Fatigue
3. Swelling in the ankles, feet, legs, abdomen and
veins in the neck
4. Dizziness
5. Lightheadedness
6. Fainting during physical activity
7. Arrhythmias (irregular heartbeats)
8. Chest pain, especially after physical exertion or
heavy meals
9. Heart murmurs (unusual sounds associated with
heartbeats)
DIAGNOSTIC TESTS /
PROCEDURES
 DIAGNOSTIC TESTS
Blood tests
Chest X-ray
Electrocardiogram (EKG or ECG): An EKG can be
used to detect cardiomyopathy as well as other
problems, including heart attacks, arrhythmias
(irregular heartbeats) and heart failure.
Holter and event monitors: A Holter monitor records
the heart’s electrical activity for a full 24- or 48-hour
period. An event monitor records your heart’s
electrical activity only at certain times.
Echocardiogram (Echo): It shows how well your
heart is working as well as its size and shape. There
are several types of echocardiography, including
“stress echo,” which is administered as part of a
stress test. Another type, transesophageal echo (or
TEE), provides a view of the back of the heart.
Stress test: In a stress test, the aim is to make your
heart work hard (and beat fast) while tests are
performed. These tests may include nuclear heart
scanning, echo, and positron emission tomography
(PET) scanning. You’ll be asked to walk in place on
an inclined treadmill. If you are unable to exercise,
you may be given medicine to simulate the effects of
exertion.
 DIAGNOSTIC PROCEDURES
Cardiac catheterization
Coronary angiography
Myocardial biopsy
Genetic testing
DIFFERENTIAL
DIAGNOSIS
Aortic Stenosis
Genetics of Fabry Disease
Hypertensive Heart Disease
Paediatric Supravalvar Aortic Stenosis
Type II Glycogen Storage Disease (Pompe Disease)
Myocarditis
Acute Pericarditis
Cardiac Tamponade
Acute Coronary Syndrome
Constrictive Pericarditis
Hyperthyroidism
Heavy Metal Toxicity