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Cardiomyopathy is the deterioration of the cardiac muscle of the heart
wall. Cardiomyopathies can generally be categorized into two groups:
ischemic cardiomyopathy and nonischemic cardiomyopathy.
Ischemic cardiomyopathy is weakness in the muscle of the heart due to
coronary artery disease. Individuals with ischemic cardiomyopathy
typically have a history of myocardial infarction (heart attack).
Nonischemic cardiomyopathy is weakness in the muscle of the heart that
is not due to coronary artery disease. To make a diagnosis of
nonischemic cardiomyopathy, significant coronary artery disease should
be ruled out. The term nonischemic cardiomyopathy does not describe the
etiology of weakened heart muscle. The nonischemic cardiomyopathies are
a mixed-bag of disease states, each with their own causes.
Nonischemic cardiomyopathy has a number of causes including drug and
alcohol toxicity, certain infections, and various genetic and idiopathic
(i.e. unknown) causes.
There are four main types of nonischemic cardiomyopathy:
Cardiomyopathy can lead to heart failure as the pumping efficiency of
the heart is diminished. People with cardiomyopathy are often at risk of
arrhythmia and/or sudden cardiac death.
Dilated cardiomyopathy (DCM) is the commonest form of cardiomyopathy,
and one of the leading indications for heart transplantation. In DCM the
heart (especially the left ventricle) is enlarged and weakened.
Approximately 40% of cases are familial, but the genetics are poorly
understood compared with HCM. Patients receiving anthracycline therapy
(e.g. doxorubicin) are at risk of developing dilated CM if they receive
more than a total cummulative dose during their life-time.
Hypertrophic cardiomyopathy (HCM) is a genetic disorder caused by
various mutations in genes encoding sarcomeric proteins. In
heart muscle is thickened, which can obstruct blood flow and prevent the
heart from functioning properly.
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.
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