Cardiomyopathies are diseases of the heart muscle where the heart function is impaired, but without any known cardiovascular disease (like hypertension, CAD, or valvular disease).
Types of Cardiomyopathy (WHO Classification):
- Dilated Cardiomyopathy (DCM) – Heart is dilated and weak
- Hypertrophic Cardiomyopathy (HCM) – Thickened heart muscle.
- Restrictive Cardiomyopathy (RCM) – Stiff heart walls.
Mnemonic: "D-H-R" (Dilated, Hypertrophic, Restrictive)
1. DILATED CARDIOMYOPATHY (DCM)
Definition:
Dilated cardiomyopathy is enlargement (dilation) of the heart chambers,
mainly the left ventricle (LV), causing weak contractions and leading
to heart failure.
Causes of DCM:
• Idiopathic (Unknown cause – Most Common).
• Viral Myocarditis (Coxsackie Virus).
• Alcohol Abuse (Alcoholic Cardiomyopathy).
• Genetic (Familial DCM).
• Toxins (Drugs like Doxorubicin).
Mnemonic: "I.V.A.G.T." (Idiopathic, Viral, Alcohol, Genetic, Toxins)
Symptoms of DCM:
• Breathlessness (Exertional, Orthopnea, PND).
• Fatigue, Weakness.
• Swelling in Feet & Abdomen (Edema, Ascites).
• Palpitations (Due to Arrhythmias).
Mnemonic: "B.F.S.P." (Breathlessness, Fatigue, Swelling, Palpitations)
Diagnosis of DCM:
• Chest X-ray → Cardiomegaly, Pulmonary Congestion.
• ECG → Sinus Tachycardia, Arrhythmias, LBBB.
• ECHO (Best Test) → Dilated LV, Poor EF%.
Mnemonic: "C.E.E." (Chest X-ray, ECG, Echo – Best Test)
Treatment of DCM:
• Diuretics (Reduce Swelling).
• ACE Inhibitors (Improve Heart Function).
• Beta-Blockers (Reduce Heart Workload).
• Anticoagulants (If Thrombus is Present).
Mnemonic: "D.A.B.A." (Diuretics, ACEI, Beta-Blockers, Anticoagulants)
2. HYPERTROPHIC CARDIOMYOPATHY (HCM)
Definition:
HCM is thickening (hypertrophy) of the left ventricle (LV) without an
obvious cause, leading to diastolic dysfunction and sudden
cardiac death in young athletes.
Causes of HCM:
• Genetic (Autosomal Dominant – 55%).
• Abnormal Heart Muscle Fiber Arrangement.
• Increased Sensitivity to Catecholamines.
Mnemonic: "G.A.C." (Genetic, Abnormal Fibers, Catecholamines)
Symptoms of HCM:
• Exertional Dyspnea (Main Symptom).
• Chest Pain (Atypical Angina).
• Palpitations, Syncope (Due to Arrhythmias).
Mnemonic: "D.C.P." (Dyspnea, Chest Pain, Palpitations)
Signs & Murmurs in HCM:
• Bifid Pulse ("Bisferiens Pulse").
• Systolic Ejection Murmur (Increases on Standing, Decreases on
Squatting).
Mnemonic: "B.S." (Bisferiens Pulse, Systolic Murmur)
Diagnosis of HCM:
• ECG → LVH, Deep Q Waves, Arrhythmias.
• ECHO (Best Test) → Thickened Septum, Small LV Cavity.
Mnemonic: "E.E." (ECG, Echo – Best Test)
Treatment of HCM:
• Beta-Blockers (Reduce Heart Workload).
• Calcium Channel Blockers (Verapamil – Improves Diastolic Function).
• Avoid Digoxin & Diuretics (Worsen Symptoms).
Mnemonic: "B.C.A." (Beta-Blockers, Calcium Blockers, Avoid Digoxin)
3. RESTRICTIVE CARDIOMYOPATHY (RCM)
Definition:
RCM is stiffening of the heart walls (myocardium), causing difficulty
in heart filling (diastolic dysfunction), while systolic function remains
normal.
Causes of RCM:
• Amyloidosis (Most Common Cause).
• Sarcoidosis.
• Hemochromatosis (Iron Overload).
• Fibrosis After Radiation Therapy.
Mnemonic: "A.S.H.F." (Amyloidosis, Sarcoidosis, Hemochromatosis, Fibrosis)
Symptoms of RCM:
• Breathlessness & Fatigue.
• Right Heart Failure Signs (Edema, JVP Raised, Hepatomegaly).
Mnemonic: "B.R." (Breathless, Right HF Signs)
Diagnosis of RCM:
• ECG → Low Voltage QRS.
• ECHO (Best Test) → Thick Stiff Walls, Normal LV Size.
Mnemonic: "E.E." (ECG, Echo – Best Test)
Treatment of RCM:
• Diuretics (Reduce Congestion).
• Calcium Channel Blockers (Improve Relaxation).
• Treat Underlying Cause (E.g., Remove Excess Iron in Hemochromatosis).
Mnemonic: "D.C.T." (Diuretics, Calcium Blockers, Treat Cause)
SPECIAL TYPES OF CARDIOMYOPATHY
Alcoholic Cardiomyopathy:
• Due to Chronic Alcohol Intake → Reversible if Alcohol is Stopped.
• Symptoms & Treatment Same as DCM.
Mnemonic: "A.A.R." (Alcohol, Arrhythmias, Reversible)
Peripartum Cardiomyopathy:
• Occurs in Late Pregnancy or After Delivery.
• Presents Like DCM → High Mortality.
Mnemonic: "P.L.H." (Pregnancy, Like DCM, High
Mortality)
Takotsubo Cardiomyopathy ("Broken Heart Syndrome")
• Triggered by Emotional Stress → Mimics Heart Attack.
• Reversible If Stress is Managed.
Mnemonic: "T.E.R." (Takotsubo, Emotional Trigger,
Reversible)
FINAL REVISION WITH MNEMONICS
- Types of Cardiomyopathy = "D-H-R" (Dilated, Hypertrophic, Restrictive)
- DCM = "I.V.A.G.T." (Idiopathic, Viral, Alcohol, Genetic, Toxins)
- HCM = "G.A.C." (Genetic, Abnormal Fibers, Catecholamines)
- RCM = "A.S.H.F." (Amyloidosis, Sarcoidosis, Hemochromatosis, Fibrosis)
- Diagnosis = "C.E.E." (Chest X-ray, ECG, Echo – Best Test)
- Treatment = "D.A.B.A." (Diuretics, ACEI, Beta-Blockers, Anticoagulants)
