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Cardiomyopathy, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

Diseases of the myocardium associated with cardiac dysfunction: 
  • Dilated:

    • Idiopathic in 25% of all cases of heart failure

  • Hypertrophic

  • Restrictive

  • Arrhythmogenic right ventricular (RV)

  • Unc...

Diagnosis

Signs and Symptoms

History

  • Antecedent illness or exposure:

    • Chemotherapy

    • HIV

    • Lyme disease

    • Viral

  • Underlying systemic condition:

    • Hemochromatosis

    • Sarcoidosis

    • Pregnancy

  • Substance abuse history

  • Family history...

Treatment

Pre-Hospital

  • Monitor

  • Oxygen

  • Avoid or use a lower dose of nitroglycerin in suspected HCM

  • Decompensated heart failure:

Initial Stabilization/Therapy

Follow-Up

Disposition

Admission Criteria

  • New or suspected cardiomyopathy

  • Syncope in which dysrhythmias or HCM are possible etiologies

  • Familial history of premature sudden death

  • Cardiogenic shock

Discharge Criteria

Pearls and Pitfalls

  • Emergency physician bedside echocardiography is a useful tool for patients with syncope or exertional symptoms

  • Obtaining family history in suspected cardiomyopathy

Additional Reading

  • ACC/AHA Guidelines for the diagnosis and treatment of hypertrophic cardiomyopathy. J Am Coll Cardiol.  2011;58(25):2703–2738.

  • Bybee  KA, Prasad  A. Stress-related cardiomyopathy...

Codes

ICD9

  • 425.4 Other primary cardiomyopathies

  • 425.18 Other hypertrophic cardiomyopathy

  • 674.54 Peripartum cardiomyopathy, postpartum condition or complication

  • 425.11 Hypertrophic obstructive cardiomyopat...

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