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Cardiomyopathy II: Dilated Cardiomyopathy

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...

Cardiomyopathy I: Introduction and Classification

Cardiomyopathy I: Introduction and Classification

Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...

Cardiomyopathy IV: Restrictive Cardiomyopathy

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...

Cardiomyopathy V: Interprofessional Care

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...

Heart Failure II: Pathophysiology

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...

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Investigating the Pathogenesis of MYH7 Mutation Gly823Glu in Familial Hypertrophic Cardiomyopathy using a Mouse Model

Investigating the Pathogenesis of MYH7 Mutation Gly823Glu in Familial Hypertrophic Cardiomyopathy using a Mouse Model

Published on: August 8, 2022

One heart, two cardiomyopathies.

Vassilis Vassiliou¹, Bobby Agrawal, Alisdair Ryding

¹Department of Cardiology, Papworth Hospital, Cambridge, UK. vassiliou@doctors.org.uk

BMJ Case Reports

|June 8, 2012

Summary

This case highlights a rare presentation of chest pain mimicking myocardial infarction. The patient experienced both Tako-tsubo cardiomyopathy and hypertrophic cardiomyopathy, despite having clear coronary arteries.

Area of Science:

Cardiology
Cardiovascular Imaging
Internal Medicine

Background:

Acute chest pain with ECG changes often indicates myocardial infarction.
Coronary artery disease is the most common cause of acute myocardial infarction.

Observation:

A 63-year-old woman presented with symptoms of acute myocardial infarction but had unobstructed coronary arteries.
Left ventriculography revealed apical hypokinesis and basal hyperkinesis, characteristic of Tako-tsubo cardiomyopathy.
Echocardiography showed left ventricular hypertrophy and dynamic outflow obstruction with mitral regurgitation.

Findings:

The patient was diagnosed with both Tako-tsubo cardiomyopathy and hypertrophic cardiomyopathy.
Despite initial recovery, persistent left ventricular hypertrophy and dynamic obstruction were noted on outpatient MRI.

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This case underscores the importance of considering non-coronary causes of myocardial infarction symptoms.

Implications:

This presentation challenges typical diagnostic pathways for acute chest pain.
It emphasizes the need for comprehensive cardiovascular assessment beyond coronary angiography.
Understanding the coexistence of these cardiomyopathies is crucial for accurate diagnosis and management.