Opened left ventricle of heart shows a thickened, dilated left ventricle with subendocardial fibrosis manifested as increased whiteness of endocardium. Autopsy.

Cardiomyopathy, which literally means "heart muscle disease", is the deterioration of the function of the myocardium (i.e., the actual heart muscle) for any reason. People with cardiomyopathy are often at risk of arrhythmia and/or sudden cardiac death.^[1] Image File history File links Idiopathic_cardiomyopathy,_gross_pathology_20G0018_lores. ... Image File history File links Idiopathic_cardiomyopathy,_gross_pathology_20G0018_lores. ... Myocardium is the muscular tissue of the heart. ... A cardiac arrhythmia, also called cardiac dysrhythmia, is a disturbance in the regular rhythm of the heartbeat. ... A cardiac arrest is the cessation of normal circulation of the blood due to failure of the ventricles of the heart to contract effectively during systole. ...

Cardiomyopathies can generally be categorized into two groups, based on World Health Organization guidelines: extrinsic cardiomyopathies and intrinsic cardiomyopathies.^[2] The World Health Organization (WHO) is a specialized agency of the United Nations, acting as a coordinating authority on international public health, headquartered in Geneva, Switzerland. ...

Extrinsic cardiomyopathies

These are cardiomyopathies where the primary pathology is outside the myocardium itself. Most cardiomyopathies are extrinsic, because by far the most common cause of a cardiomyopathy is ischemia. The World Health Organization calls these specific cardiomyopathies:^[2] Pathology (from Greek pathos, feeling, pain, suffering; and logos, study of; see also -ology) is the study of the processes underlying disease and other forms of illness, harmful abnormality, or dysfunction. ... In medicine, ischemia (Greek ισχαιμία, isch- is restriction, hema or haema is blood) is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. ...

• Ischemic (or ischaemic) cardiomyopathy
• Hypertensive cardiomyopathy
• Valvular cardiomyopathy
• Inflammatory cardiomyopathy
• Cardiomyopathy secondary to a systemic disease
• Alcoholic cardiomyopathy

Ischemic cardiomyopathy

Ischemic cardiomyopathy is a weakness in the muscle of the heart due to inadequate oxygen delivery to the myocardium with coronary artery disease being the most common cause. Anemia and sleep apnea are relatively common conditions that can contribute to ischemic myocardium and hyperthyroidism can cause a 'relative' ischemia secondary to high output heart failure. Individuals with ischemic cardiomyopathy typically have a history of myocardial infarction (heart attack), although longstanding ischemia can cause enough damage to the myocardium to precipitate a clinically significant cardiomyopathy even in the absence of myocardial infarction. In a typical presentation, the area of the heart affected by a myocardial infarction will initially become necrotic as it dies, and will then be replaced by scar tissue (fibrosis). This fibrotic tissue is akinetic; it is no longer muscle and cannot contribute to the heart's function as a pump. If this akinetic region of the heart is substantial enough, the affected side of the heart (i.e. the left or right side) will go into failure, and this failure is the functional result of an ischemic cardiomyopathy. Coronary heart disease (CHD), also called coronary artery disease (CAD) and atherosclerotic heart disease, is the end result of the accumulation of atheromatous plaques within the walls of the arteries that supply the myocardium (the muscle of the heart). ... Acute myocardial infarction (AMI or MI), commonly known as a heart attack, is a disease that occurs when the blood supply to a part of the heart is interrupted. ... Myocardium is the muscular tissue of the heart. ... Necrosis (in Greek Νεκρός = Dead) is the name given to unprogrammed death of cells/living tissue (compare with apoptosis - programmed cell death). ... Fibrosis is the formation or development of excess fibrous connective tissue in an organ or tissue as a reparative or reactive process, as opposed to formation of fibrous tissue as a normal constituent of an organ or tissue. ... Congestive heart failure (CHF), also called congestive cardiac failure (CCF) or just heart failure, is a condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood throughout the body. ...

Cardiomyopathy due to systemic diseases

Many diseases can result in cardiomyopathy. These include diseases like hemochromatosis, (an abnormal accumulation of iron in the liver and other organs), amyloidosis (an abnormal accumulation of the amyloid protein), diabetes, hyperthyroidism, lysosomal storage diseases and the muscular dystrophies.

Intrinsic cardiomyopathies

An intrinsic cardiomyopathy is weakness in the muscle of the heart that is not due to an identifiable external cause. To make a diagnosis of an intrinsic cardiomyopathy, significant coronary artery disease should be ruled out (amongst other things). The term intrinsic cardiomyopathy does not describe the specific etiology of weakened heart muscle. The intrinsic cardiomyopathies are a mixed-bag of disease states, each with their own causes. Etiology (alternately aetiology, aitiology) is the study of causation. ...

Intrinsic cardiomyopathy has a number of causes including drug and alcohol toxicity, certain infections (including Hepatitis C), and various genetic and idiopathic (i.e., unknown) causes. Oral medication A medication is a licenced drug taken to cure or reduce symptoms of an illness or medical condition. ... Ethanol, also known as ethyl alcohol or grain alcohol, is a flammable, colorless, mildly toxic chemical compound with a distinctive perfume-like odor, and is the alcohol found in alcoholic beverages. ... An infection is the detrimental colonization of a host organism by a foreign species. ... Cirrhosis of the liver and liver cancer may ensue from Hepatitis C. Hepatitis C is a blood-borne, infectious, viral disease that is caused by a hepatotropic virus called Hepatitis C virus (HCV). ... Genetics (from the Greek genno γεννώ= give birth) is the science of genes, heredity, and the variation of organisms. ... Idiopathic means arising spontaneously or from an obscure or unknown cause. ...

There are four main types of intrinsic cardiomyopathy:^[2][3]

• Dilated cardiomyopathy (DCM), the most common form, and one of the leading indications for heart transplantation. In DCM the heart (especially the left ventricle) is enlarged and the pumping function is diminished. Approximately 40% of cases are familial, but the genetics are poorly understood compared with HCM. In some cases it manifests as peripartum cardiomyopathy, and in other cases it may be associated with alcoholism.
• Hypertrophic cardiomyopathy (HCM or HOCM), a genetic disorder caused by various mutations in genes encoding sarcomeric proteins. In HCM the heart muscle is thickened, which can obstruct blood flow and prevent the heart from functioning properly.
• Arrhythmogenic right ventricular cardiomyopathy (ARVC) arises from an electrical disturbance of the heart in which heart muscle is replaced by fibrous scar tissue. The right ventricle is generally most affected.
• Restrictive cardiomyopathy (RCM) is the least common cardiomyopathy. The walls of the ventricles are stiff, but may not be thickened, and resist the normal filling of the heart with blood. A rare form of restrictive cardiomyopathy is the obliterative cardiomyopathy, seen in the hypereosinophilic syndrome. In this type of cardiomyopathy, the myocardium in the apicies of the left and right ventricles become thickened and fibrotic, causing a decrease in the volumes of the ventricles and a type of restrictive cardiomyopathy.

Dilated cardiomyopathy or DCM (also known as congestive cardiomyopathy), is a disease of the myocardium (the muscle of the heart) in which a portion of the myocardium is dilated, often without any obvious cause. ... In the heart, a ventricle is a chamber which collects blood from an atrium (another heart chamber) and pumps it out of the heart. ... Genetics (from the Greek genno γεννώ= give birth) is the science of genes, heredity, and the variation of organisms. ... Peripartum cardiomyopathy (PPCM) is a form of dilated cardiomyopathy that presents in the third trimester of pregnancy or in the early post partum period. ... Hypertrophic cardiomyopathy, or HCM, is a disease of the myocardium (the muscle of the heart) in which a portion of the myocardium is hypertrophied (thickened) without any obvious cause. ... A genetic disorder, or genetic disease, is a disease caused by abnormal expression of one or more genes in a person causing a clinical phenotype. ... In biology, mutations are changes to the genetic material (either DNA or RNA). ... Image of sarcomere A sarcomere is the basic unit of a cross striated muscles myofibril. ... Arrhythmogenic right ventricular dysplasia (ARVD, also known as arrhythmogenic right ventricular cardiomyopathy or ARVC) is a type of nonischemic cardiomyopathy that involves primarily the right ventricle. ... The right ventricle is one of four chambers (two atria and two ventricles) in the human heart. ... Restrictive cardiomyopathy (RCM) is the least common cardiomyopathy. ... The hypereosinophilic syndrome is a disease process characterized by a persistently elevated eosinophil count (≥ 1500 eosinophils/mm³) in the blood for at least six months without any recognizable cause after a careful workup, with evidence of involvement of either the heart, nervous system, or bone marrow. ...

Treatment

Treatment depends on the type of cardiomyopathy, but may include medical therapy and implanted artificial pacemakers. The goal of treatment is often symptom relief, with the underlying condition unaffected. Some patients may eventually require a heart transplant. Treatment of cardiomyopathy (and other heart diseases) using alternative methods such as stem cell therapy is commercially available but is not supported by convincing evidence. A pacemaker (or artificial pacemaker, so as not to be confused with the hearts natural pacemaker) is a medical device designed to regulate the beating of the heart. ... Mouse embryonic stem cells. ... Evidence-based medicine (EBM) applies the scientific method to medical practice. ...

References

2006 (MMVI) is a common year starting on Sunday of the Gregorian calendar. ... September 28 is the 271st day of the year (272nd in leap years) in the Gregorian calendar. ...

External links

• The Cardiomyopathy Association
• Cardiomyopathy information from Seattle Children's Hospital Heart Center
• Information from the Stanford Hypertrophic Cardiomyopathy Center
• Cardiomyopathy-related antibodies at antibodypatterns.com