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Dilated cardiomyopathy
From WikEM
Contents
Background
- Heart is dilated with poor contraction and EF
- Idiopathic form accounts for 25% of CHF
- Viral/chronic myocarditis is most common identifiable causes
- Other causes
- Ischemic
- Other infectious - HIV, Lyme, Chagas
- Familial dilated cardiomyopathy
- Hypertensive dilated cardiomyopathy
- Toxic (EtOH/beriberi, cocaine, meth, chemo, heavy metals)
- Hyperthyroidism
- Sarcoidosis
- Peripartum cardiomyopathy
- Kawasaki disease
- Autoimmune, SLE
- Connective tissue disease
- Infiltrative disease
- Mitochondrial disease
- Tachycardia-mediated
- ESRD
- Eosinophilic (Churg Strauss)
Evaluation
- CHF symptoms
- CXR
- Cardiomegaly, pulmonary venous htn
- ECG
- LV hypertrophy, poor R wave progression
- Ultrasound
- Bedside (for gross function)
- TTE/TEE for EF
Differential Diagnosis
Cardiomyopathy
- Dilated cardiomyopathy
- Hypertrophic cardiomyopathy
- Restrictive cardiomyopathy
- Peripartum cardiomyopathy
- Takotsubo cardiomyopathy
- Arrhythmogenic right ventricular dysplasia
Management
- Treat the underlying diseae
- Similar to CHF exacerbation
- Ensure exacerbation not due to ischemia
