In its simplest form, cardiomyopathy (CMP) can be defined as a cardiac disorder involving myocardial dysfunction. Though there are various formal definitions of CMP in the literature, the two major ones are from the World Health Organization (WHO) and from the American Heart Association (AHA). The WHO definition is more clinical, while the AHA definition is more molecular and scientific in its delineation. For the purpose of this chapter, we follow the simpler definition by WHO as it lends itself well to the echocardiographic evaluation of cardiomyopathies.
Cardiomyopathies can also be defined by their etiology, as was done also by the WHO task force in 1995. Since the etiology may not always be obvious, such as in many cases of dilated CMP, this classification is also less useful when discussing the general principles of echocardiographic diagnosis of CMP. The various types of cardiomyopathies, as classified by WHO, are listed in Table 14-1. Each type of CMP can have various etiologies, the discussion of which is beyond the scope of this chapter (see suggested reading list for further information). The various etiologies are nonetheless listed in Table 14-2. Table 14-3 demonstrates the key elements in the echocardiographic evaluation of a patient with a CMP.
TABLE 14-1The WHO Classification of Cardiomyopathies |Favorite Table|Download (.pdf) TABLE 14-1The WHO Classification of Cardiomyopathies
|Dilated CMP |
|Hypertrophic CMP |
|Restrictive CMP |
|Arrhythmogenic right ventricular CMP (dysplasia) |
|Other unclassified cardiomyopathies |
TABLE 14-2Partial Listing of Etiologies of Cardiomyopathies |Favorite Table|Download (.pdf) TABLE 14-2 Partial Listing of Etiologies of Cardiomyopathies
|Type of CMP ||Etiologies (examples) |
|Dilated CMP ||Idiopathic (mostly genetic) |
| ||Familial |
| ||Myocardial ischemia/infarction |
| ||End-stage valvular heart disease |
| ||End-stage hypertensive heart disease |
| ||Infectious (viral myocarditis, Chagas, bacterial, etc.) |
| ||Toxic/metabolic (chemotherapy, alcoholic, cocaine, etc.) |
| ||Tachycardia-induced |
| ||Peripartum |
| ||Rheumatologic (SLE, scleroderma) |
| ||Endocrine disorders (diabetes, thyroid disease, etc.) |
| ||Neuromuscular diseases (Duchenne’s, myotonic dystrophy, etc.) |
| ||Electrolyte abnormalities (hypocalcemia, hypophosphatemia, etc.) |
| ||Nutritional deficiencies (thiamine, carnitine, etc.) |
| ||Infiltrative diseases (usually end-stage) |
|Hypertrophic CMP ||Idiopathic/familial (asymmetric) |
| ||Concentric |
| ||Apical |
|Restrictive CMP ||Idiopathic/familial |
| ||Diabetes |
| ||Infiltrative (amyloidosis, sarcoidosis, etc.) |
| ||Storage diseases (hemochromatosis, glycogen storage diseases, etc.) |
| ||Endomyocardial fibrosis |
| ||Rheumatologic (scleroderma) |
| ||Radiation |
|Unclassified Cardiomyopathies ||Isolated LV noncompaction |
| ||LV apical ballooning syndrome |
| ||Endocardial fibroelastosis |
TABLE 14-3The Key Elements in the Echocardiographic Evaluation of a Patient with a CMP |Favorite Table|Download (.pdf) TABLE 14-3 The Key Elements in the Echocardiographic Evaluation of a Patient with a CMP
|Focused Assessment ||Findings |
|Assessment of chamber sizes and mass ||Left ventricular and left atrial dilatation |
| ||Right ventricular dilatation, either primarily or from pulmonary hypertension |
| ||Increased cardiac mass ...|
Log In to View More
If you don't have a subscription, please view our individual subscription options below to find out how you can gain access to this content.
Want remote access to your institution's subscription?
Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.
If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.
AccessAnesthesiology Full Site: One-Year Subscription
Connect to the full suite of AccessAnesthesiology content and resources including procedural videos, interactive self-assessment, real-life cases, 20+ textbooks, and more
Pay Per View: Timed Access to all of AccessAnesthesiology
24 Hour Subscription $34.95
48 Hour Subscription $54.95
Pop-up div Successfully Displayed
This div only appears when the trigger link is hovered over.
Otherwise it is hidden from view.