*```Cardiomyopathy``` * Is a group of diseases that affect the heart muscle, altering its structure and function, and impairing the heart’s ability to pump blood effectively. *1. Dilated Cardiomyopathy (DCM)* - *Definition*: Enlargement and weakening of the heart chambers, especially the left ventricle. - *Pathophysiology*: - Myocardial damage → decreased contractility → chamber dilation → reduced ejection fraction. - Causes: genetic, viral infections, alcohol, toxins, pregnancy. - *Signs/Symptoms*: - Dyspnea, fatigue, orthopnea, peripheral edema, palpitations, S3 heart sound. - *Management*: - ACE inhibitors, beta-blockers, diuretics, anticoagulants. - Lifestyle changes: low-sodium diet, fluid restriction. - In severe cases: ICD, heart transplant. - *Diagnostics*: - Echocardiogram, ECG, chest X-ray, cardiac MRI, BNP, cardiac catheterization. *2. Hypertrophic Cardiomyopathy (HCM)* - *Definition*: Abnormal thickening of the heart muscle, most often the interventricular septum. - *Pathophysiology*: - Genetic mutation → thickened myocardium → impaired relaxation and obstruction of blood flow. - *Signs/Symptoms*: - Often asymptomatic, or: chest pain, syncope, dyspnea, palpitations, sudden cardiac death in young people. - *Management*: Beta-blockers, calcium channel blockers. - Avoid strenuous activity. - ICD for high-risk cases. - *Diagnostics*: - Echocardiogram (asymmetric hypertrophy), ECG (LVH), Holter monitor, genetic testing. *3. Restrictive Cardiomyopathy (RCM)* - *Definition*: Stiff ventricular walls cause impaired filling but preserved systolic function. - *Pathophysiology*: - Often secondary to infiltrative diseases (e.g., amyloidosis, hemochromatosis, sarcoidosis). - *Signs/Symptoms*: - Fatigue, dyspnea, peripheral edema, ascites, JVD. - *Management*: - Diuretics, rate control, treat underlying cause. - *Diagnostics*: - Echocardiogram, endomyocardial biopsy, cardiac MRI, ECG. *4. Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)* - *Definition*: Replacement of right ventricular myocardium with fibrous and fatty tissue. - *Pathophysiology*: - Genetic mutations → structural changes → arrhythmias. - *Signs/Symptoms*: - Palpitations, syncope, ventricular arrhythmias, sudden cardiac death. - *Management*: - Antiarrhythmics, ICD, activity restriction. - *Diagnostics*: - ECG (T-wave inversions), cardiac MRI, biopsy, genetic testing. *5. Takotsubo Cardiomyopathy (Stress-induced)* - *Definition*: Temporary heart muscle dysfunction due to acute stress. *Pathophysiology*: - Catecholamine surge → apical ballooning. - *Signs/Symptoms*: - Mimics MI: chest pain, ECG changes, elevated troponins. - *Management*: - Supportive care, beta-blockers, ACE inhibitors. - *Diagnostics*: - Echo (ballooning), coronary angiography (normal arteries).