Cardiomyopathies

Abstract

September 2000

Section 1 Cardiovascular Medicine

XIV Cardiomyopathies

G. William Dec, M.D.
Associate Professor of Medicine, Harvard Medical School; and Medical Director, Cardiac Transplantation Program, and Director, Clinical Cardiology, Massachusetts General Hospital

Roman W. DeSanctis, M.D.
Evelyn and James Jenks/Paul Dudley White Professor of Medicine, Harvard Medical School, and Physician and Director (Emeritus) of Clinical Cardiology, Massachusetts General Hospital

The cardiomyopathies are a diverse group of diseases characterized by myocardial dysfunction that is not related to the usual causes of heart disease, notably coronary atherosclerosis, valvular dysfunction, and hypertension. Cardiomyopathies are classified according to hemodynamic characteristics and etiology. In this chapter, the four major hemodynamic categories of cardiomyopathies (i.e., dilated, hypertrophic, restrictive, and obliterative) and their etiologies are discussed. Causes are poorly understood, and the disease is considered idiopathic in many cases; recognized causes and associations include certain drugs and toxins and several infectious, systemic, infiltrative, nutritional, and ischemic disorders. Pathology, pathophysiology, diagnosis, differential diagnosis, course and prognosis, genetics, screening, and treatment are covered in this chapter. Tables present the morphologic and hemodynamic characteristics of the cardiomyopathies, etiologic classifications of cardiomyopathies, vasodilator drugs used in therapy for chronic congestive heart failure, the use of beta-adrenergic blockers in heart failure, and factors that influence the degree of obstruction in hypertrophic cardiomyopathy. This chapter contains 118 references.

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