An Overview of the Cardiomyopathies

Abstract

Cardiomyopathies constitute a heterogeneous group of heart diseases. In fact, cardiomyopathies is a major cause of death either as end-stage heart failure or sudden cardiac death. Even though prognosis is, in many cases, poor there are several approaches to optimal disease management, which improves outcome and implies better quality of life including reduced risk of hospitalization. Differentiation of underlying etiology in individual cases of cardiomyopathies requires careful clinical evaluation. Echocardiography is the cornerstone in initial evaluation and follow-up but cardiac magnetic resonance provides additional value. ECG, biomarkers, detailed history taking and extracardiac features may provide clues to less common entities. While forty years ago cardiomyopathy was defined as heart muscle disease of unknown origin, the underlying pathophysiology has now been elucidated. Indeed, the last decades the genetic explanations have evolved. Advanced treatment with pacemakers, including cardiac resynchronization, implantable defibrillators, and mechanical devices in the most severe cases are nowadays available for many patients. The evidence-based pharmacological approach to heart failure provides multiple interaction of pathophysiological pathways and has improved outcome. In selected cases specific agents are indicated why differential diagnosis is crucial and the genetic link imply cascade screening. This chapter aims to present a comprehensive overview of the cardiomyopathies, categorized into: dilated-, hypertrophic-, restrictive-, arrhythmogenic and unclassified cardiomyopathy.