Cardiomyopathy Imaging

Excerpt

Cardiomyopathies are a heterogenic group of diseases of the myocardium, which further classify into primary “confined to the heart, “or secondary “related to systemic disease.” The primary cardiomyopathies are divided into genetic “including hypertrophic, arrhythmogenic right ventricular, left ventricular noncompaction, Danon glycogen storage disease and others”; and acquired “including acute myocarditis, stress-induced (Takotsubo), peripartum, and tachycardia-induced cardiomyopathies." The secondary cardiomyopathies occur due to systemic diseases. These include infiltrative diseases such as amyloidosis, Gaucher disease, Hunter disease, and Hurler disease. Storage diseases, medication toxicity, inflammatory disease, and endocrinology diseases can also lead to secondary cardiomyopathy.

Diagnosis of the etiology of cardiomyopathy starts with a thorough history and physical exam, including obtaining detailed social and family history, a careful review of medication and substance use, and followed by diagnostic tools including electrocardiogram, laboratory testing, imaging studies, and may require a myocardial biopsy to reach the definitive diagnosis. Echocardiogram, cardiac MRI, cardiac CT, and nuclear medicine imaging are the primary imaging modalities used for both work up and follow up on patients with cardiomyopathies.