Cardiomyopathy, 425.4
II. Types.
A. Dilated (congestive).
1. Abnormal systolic pump function
2. Dilated ventricles without proportionate compensatory hypertrophy
3. Systolic heart failure
B. Hypertrophy
1. Autosomal dominant disorder
2. Stiff left ventricle during diastole that restricts ventricular filling
3. Ventricular hypertrophy that occurs without dilatation or a thickening septum
4. Diastolic heart failure
C. Restrictive.
1. Inadequate diastolic filling
2. Rigid ventricular walls
3. Diastolic heart failure
III. Etiology/incidence.
A. Dilated (congestive).
1. Caused by ischemic heart disease, alcoholism, systemic lupus erythematosus, toxins, cocaine; also, idiopathic causes
2. Most common type of cardiomyopathy
3. Approximately 1% of the general population is affected; 10% of these are older than 80 years of age.
C. Restrictive.
1. Related to a variety of conditions
a. Sarcoidosis
b. Endomyocardial fibrosis (after open heart surgery)
c. Exposure
d. Idiopathic causes
2. Relatively uncommon
IV. Subjective and physical examination findings.
Get Clinical Tree app for offline access
A. Dilated (congestive)—associated with left or biventricular CHF.
1. Increased jugular venous distention
2. Low pulse pressure
3. S3 and/or S4 heart sounds
4. Peripheral edema
5. Rales
6. Dyspnea
7. Orthopnea
8. Paroxysmal nocturnal dyspnea
9. Mitral or tricuspid regurgitation (rare)
10. Cardiomegaly
B. Hypertrophic.
1. Dyspnea
2. Chest pain
3. Syncope
4. Murmur—harsh, “diamond-shaped” (crescendo-decrescendo) systolic, at the left sternal border; decreases with squatting and increases with the Valsalva maneuver
5. S4 heart sound
6. Maximized apical pulse (double or triple)
C. Restrictive—associated with right-sided CHF.
1. Dyspnea
2. Fatigue
3. Weakness
4. Edema
5. Jugular venous distention
6. Ascites
7. Murmurs (regurgitant)
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree