Cardiomyopathy

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Cardiomyopathy Types

Causes
Primary Cardiomyopathy (intrinsic, isolated cardiac effects)

Acquired Primary Cardiomyopathy
1. See Myocarditis
2. Tachycardia induced Cardiomyopathy
  1. Atrial Fibrillation with persistent rapid ventricular rate
  2. Grogan's Syndrome
3. Takotsuba Cardiomyopathy (Stress Cardiomyopathy)
4. Peripartum Cardiomyopathy (or Postpartum Cardiomyopathy)
  1. Associated with Obesity, age over 30 years, Multiparity, and Preeclampsia
  2. Onset from third trimester to five months postpartum
Genetic Primary Cardiomyopathy
1. Hypertrophic Cardiomyopathy
  1. Autosomal Dominant condition with Incidence of 1 in 500
  2. Leading cause of Sudden Death in Athletes
2. Arrhythmogenic Right Ventricular Cardiomyopathy (rare, hereditary)
3. Left ventricular compaction
4. Other genetic disorders
  1. Ion channel disorder
  2. Mitochondrial Myopathy
Mixed Primary Cardiomyopathy
1. Restrictive Cardiomyopathy (rare)
2. Dilated Cardiomyopathy
  1. Most common Cardiomyopathy
  2. Third leading cause of Heart Failure behind Coronary Artery Disease and Hypertension

Causes
Secondary Cardiomyopathy (extrinsic or systemic condition related)

See Myocarditis
Autoimmune, Collagen Vascular Disease or inflammatory conditions
Endocrine conditions
1. Acromegaly
2. Diabetes Mellitus
  1. Multi-factorial (LVH, micro/macro coronary disease, endothelial dysfunction, Autonomic Dysfunction)
3. Hyperparathyroidism
4. Hyperthyroidism (high output Heart Failure)
5. Hypothyroidism
6. Obesity
7. Pheochromocytoma
8. Paget's Disease (high output Heart Failure)
Infectious conditions
1. Parasitic Infections
  1. Chagas Disease (Trypanosoma cruzi, most common Myocarditis cause wordwide)
  2. Trichinella species (Trichinosis roundworm)
  3. Taenia solium (Cysticercosis)
  4. Entamoeba histolytica (Amoebiasis)
2. Viral Infections
  1. Parvovirus B19 (most common Myocarditis cause in U.S. in 2017)
  2. Human Herpes Virus 6 (HH6)
  3. Coxsackie Virus B (previously most common in U.S.)
  4. Covid19
  5. Human Immunodeficiency Virus (HIV)
  6. Hepatitis C
  7. Adenovirus
  8. Epstein-Barr Virus (EBV, Mononucleosis)
  9. Influenza
  10. Cytomegalovirus (CMV)
3. Bacterial Infections
  1. Rickettsia
  2. Mycobacteria
  3. Streptococcal Pharyngitis (with secondary Acute Rheumatic Fever, Myocarditis)
  4. Lyme Disease (strongly consider in endemic areas as cause of Myocarditis)
  5. Diphtheria (toxin-induced Myocarditis)
Infiltrative conditions
1. Amyloidosis
2. Gaucher Disease
3. Hunter Syndrome
4. Hurler Syndrome
Neuromuscular conditions and Glycogen Storage Disease
1. Glycogen Storage Disease
2. Neurofibromatosis
3. Barth Syndrome
4. Muscular Dystrophy
Nutritional deficiency
1. Protein Malnutrition (Kwashiorkor)
2. Thiamine deficiency (Wet Beriberi)
3. Niacin Deficiency (Pellagra)
4. Vitamin C Deficiency (Scurvy)
5. L-Carnitine Deficiency
6. Selenium Deficiency
7. Severe Anemia (high output Heart Failure)
Toxic-metabolic conditions
1. Anabolic Steroids
2. Chloroquine (Aralen)
3. Hemochromatosis
4. Radiation Exposure including Radiation Therapy
5. Carbon Monoxide Poisoning (Myocarditis)
6. Chronic Stimulant Abuse
  1. Cocaine and other Catecholamines
  2. Methylphenidate
7. Alcoholic Cardiomyopathy
  1. See Alcohol Related Cardiac Effects
8. AnthracyclineChemotherapy
  1. Doxorubicin (Adriamycin, Doxil)
  2. Daunorubicin (Cerubidine)
  3. Epirubicin (Ellence)
  4. Idarubicin
  5. Mitoxantrone (Novantrone)
  6. Valrubicin
9. Other Chemotherapeutic agents
  1. Cyclophosphamide
10. Heavy Metal Poisoning
11. Other medications
  1. Clozapine and other Antipsychotics (Myocarditis)
Miscellaneous conditions
1. Arteriovenous Fistula (high output Heart Failure)

Findings

See Congestive Heart Failure

Management

See Congestive Heart Failure
See causative condition for specific management

References