[Myocardial diseases: lessons from the past and future prospects]

This report provides an overview of current concepts on the cardiomyopathies. They constitute a heterogeneous group of diseases with complex interrelations between clinical manifestations, pathophysiology and therapy. Special emphasis was made to review new advances on the diagnosis and current management of patients with hypertrophic cardiomyopathy. The link between the classical knowledge and recent--still evolving--ideas is addressed to provide the--state of the art--concerning the implications on the clinical decision making process. Controversial issues such as diagnostic criteria, prognostic features and implications of electrocardiographic and echocardiographic data are revisited in brief. Data suggesting the value of dual chamber pacing as a means to relieve outflow tract obstruction and to improve symptoms in patients with hypertrophic cardiomyopathy are discussed. The molecular basis of this entity together with the characterization of the responsible genetic mutations are reviewed in detail.