ICU · Cardiovascular / cardiomyopathy

Cardiomyopathies & Myocarditis

Also known as Cardiomyopathy · Dilated cardiomyopathy · Hypertrophic cardiomyopathy · Restrictive cardiomyopathy · Arrhythmogenic right ventricular cardiomyopathy · ARVC · Takotsubo cardiomyopathy · Stress cardiomyopathy · Broken heart syndrome · Myocarditis · Giant cell myocarditis · Eosinophilic myocarditis · Fulminant myocarditis · Cardiac amyloidosis · SAM · Systolic anterior motion · LVOT obstruction · Mavacamten · Tafamidis · Cardiac MRI late gadolinium enhancement · Lake Louise criteria · Dallas criteria · HCM Risk-SCD

The four cardiomyopathies are dilated (the commonest — an enlarged LV with a reduced EF, treated with heart-failure therapy), hypertrophic (asymmetric septal LVH with a dynamic LVOT obstruction and a risk of sudden cardiac death — treat with beta-blockers, avoid vasodilators, an ICD for prevention), restrictive (amyloid, sarcoid — stiff ventricles with impaired filling, treated for the cause), and arrhythmogenic (a genetic right-ventricular cardiomyopathy). Takotsubo is a transient stress-mediated apical ballooning that mimics an anterior STEMI. Myocarditis is an inflammation of the myocardium (most commonly viral — coxsackie, parvovirus, SARS-CoV-2), presenting with chest pain, arrhythmia, heart failure, and a rising troponin with normal coronary arteries. The cardiac MRI (mid-wall late gadolinium enhancement) and the biopsy (the Dallas criteria) confirm. Treatment is supportive; most recover, but giant-cell and a fulminant case may need immunosuppression, mechanical support or a transplant.