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                                 CARDIOMYOPATHIES

                                                    Andrew Ying-Siu Lee, MD,PhD.

       Cardiomyopathies mean abnormal heart muscles not due to hypertensive, valvular, pericardial or congenital heart diseases.  Etiology include: (1) primary cardiomyopathies (idiopathic, hereditary, fibrosis), (2) secondary cardiomyopathies (infections such as viral or bacterial myocarditis, metabolic, collagen diseases such as systemic lupus erythematosus, rheumatoid arthritis, infiltrative such as amyloidosis, tumors, neuromuscular diseases such as myopathies or polyneuritis, allergy, toxic agents, endomyocardial fibrosis, post-partum, obesity, electrolyte imbalance, genetic diseases etc.)

       Cardiomyopathies are classified as :-

(1)   IDIOPATHIC DILATED CARDIOMYOPATHY:

       Characterized by cardiac enlargement with impaired systolic function in one or both ventricles.  Common symptoms include: fatigue, weakness, exercise intolerance, exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea, palpitation, chest discomfort, arrhythmias, edema, pulmonary edema etc.

       Some patients become stable after medical treatment.  However, most patients continue to worsen and die of heart failure, arrhythmias, sudden cardiac death.

(2)   HYPERTROPHIC CARDIOMYOPATHY:

       Characterized by myocardial hypertrophy with diastolic rather than systolic dysfunction. Common symptoms include: dyspnea, chest discomfort, palpitation, dizziness, fainting, sudden cardiac death.

       Therapy include medical treatment, cardiac catheterization and surgery.

(3)   RESTRICTIVE CARDIOMYOPATHY:

       Characterized by abnormal diastolic heart function due to myocardial fibrosis, infiltration, scarring.  Common symptoms include: weakness, dyspnea, exertional chest pain, edema.