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Overview of Cardiomyopathies
A cardiomyopathy is a primary disorder of the heart muscle. It is distinct from structural cardiac disorders such as coronary artery disease, valvular disorders, and congenital heart disorders. Cardiomyopathies are divided into 3 main types based on the pathologic features: (see see Figure: Forms of cardiomyopathy.)
The term ischemic cardiomyopathy refers to the dilated, poorly contracting myocardium that can occur in patients with severe coronary artery disease (with or without areas of infarction). Although it does not describe a primary myocardial disorder, the term remains in common use.
Manifestations of cardiomyopathies are usually those of heart failure and vary depending on whether there is systolic dysfunction, diastolic dysfunction, or both (see Heart Failure (HF) : Pathophysiology). Some cardiomyopathies may also cause chest pain, syncope, or sudden death.
Evaluation typically includes blood tests, ECG, chest X-ray, echocardiography and often MRI if available. Some patients require endomyocardial biopsy (transvenous right ventricular or retrograde left ventricular). Other tests are done as needed to determine the cause. Treatment depends on the specific type and cause of cardiomyopathy (see Diagnosis and Treatment of Cardiomyopathies).
Diagnosis and Treatment of Cardiomyopathies
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