TOC | Cardiology    CARDIOMYOPATHY

Hemodynamic & Morphologic Classification
1. Dilated Cardiomyopathy  
- Idiopathic
- Viral (Prodrome) Myocarditis: Cocksackie B virus, adenovirus, echovirus
- Alcoholism
- Hypertension
- Myocardial Ischemia / Infarction
- Collagen-Vascular Disease: Polymyositis, Systemic Lupus Erythematosus, others
- Chagas Disease
 -Cobalt Toxicity
- Familial
- Chemotherapy: adriamycin, ifosfamide

2. Hypertrophic Cardiomyopathy  
- Hypertension (concentric LVH)
- Aortic Stenosis (concentric LVH)
- Familial (abnormal myosin)
- Aortic Regurgitation (eccentric LVH)
- Post-MI (remodelling)
Ref:
A Systematic Review of Hypertrophic Cardiomyopathy
JAMA  March 13, 2002 - 287:10:1308 Barry J Maron
Substantial understanding has evolved regarding the epidemiology and clinical course of HCM, as well as novel treatment strategies that may alter its natural history. An appreciation that HCM, although an important cause of death and disability at all ages, does not invariably convey ominous prognosis and is compatible with normal longevity should dictate a large measure of reassurance for many patients.

3. Restrictive Cardiomyopathy  
- Pericarditis
- Pericardial Effusion
- Amyloidosis
- Hemochromatosis
- Sarcoidosis
- Endomyocardial fibrosis - Eosinophilic - Non-eosinophilic (esp in Africans)

4. Idiopathic Cardiomyopathy    

5. Obliterative (Restrictive Obliterative) Cardiomyopathy
Restrictive / Constrictive
- Pericarditis
- Pericardial Effusion
- Amyloidosis
- Hemochromatosis
- Sarcoidosis
- Endomyocardial fibrosis - Eosinophilic - Non-eosinophilic (esp in Africans)

Etiologic Classification
1. Cardiomyopathies of Unknown Etiology

• Idiopathic dilated cardiomyopathy
• Peripartum cardiomyopathy
• Hypertrophic cardiomyopathy
• Endomyocardial fibrosis
• Subendocardial fibroelastosis
• Eosinophilic fibroplastic parietal endocariditis (Lofflers's)
• Right ventricular dysplasia

2. Cardiomyopathies of Known Etiology

• Ischemic cardiomyopathy
• Infectious
  (1) Viral & rickettsial myocarditis
  (2) Septic/bacterial endocariditis
  (3) Syphilis
  (4) Parasitic diseases (Chagas' disease, trichinosis)
  (5) Bacterial toxins (eg. diphtheria toxin) or hypersensitivity (rheumatic fever)
• Toxic Cardiomyopathy
  (1) Alcohol Cardiomyopathy
  (2) Cocaine
  (3) Chemotherapy agents: Adriamycin (doxorubicin), daunorubicin, cylophosphamide, etc.
  (4) Misc: cobalt, carbon tetrachloride, carbon monoxide, thioridazine drugs, antimonials
• Systemic Cardiomyopathy
  (1) Sarcoidosis
  (2) Collagen vascular diseases: lupus, etc.
  (3) Endocrine: thyrotoxicosis, myxedema, pheochromocytoma, acromegaly
  (4) Neuromuscular: muscular dystrophies, Friedreich's ataxia
• Infiltrative Cardiomyopathy
  (1) Amyloidosis
  (2) Hemochromatosis
  (3) Glycogen storage diseases
  (4) Fabry's disease (Lysosomal storage disease deficiency of a Galactosidase A)
  (5) Hurler's syndrome (Lysosomal storage disease deficiency of a Iduronidase)
  (6) Primary or metastatic tumors
• Nutritional Cardiomyopathy
  (1) Beriberi (B1 Thiamine deficiency)
  (2) Selenium deficiency
  (3) Kwashiorkor (Protein deficiency syndrome)

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Peripartum Cardiomyopathy
National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) Workshop -   Recommendations and Review
Gail D. Pearson, etc.   -   JAMA. March 1, 2000;283:1183-1188
[Peripartum cardiomyopathy is a rare lethal disease about which little is known. Diagnosis is confined to a narrow period and requires echocardiographic evidence of left ventricular systolic dysfunction. Symptomatic patients should receive standard therapy for heart failure, managed by a multidisciplinary team. If subsequent pregnancies occur, they should be managed in collaboration with a high-risk perinatal center. Systematic data collection is required to answer important questions about incidence, treatment, and prognosis.]

Ref: Outlines in Clinical Medicine on Physicians' Online 2000

03202002