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Intrinsic disease of the myocardium in which there is no structural deformity of the heart

  1. Dilated cardiomyopathy: commonest cardiomyopathy Q
    1. Cardiomegaly. CHF. S3 gallop, murmur of mitral regurgitation
    2. T/t Prolonged bed rest, anti congestive therapy including ACE inhibitors
    3. If biopsy indicates presence of active myocarditis -immunosuppressive
    4. Beta blockers-as a rule beta blockers are contraindicated in the CHF. however in dilated cardiomyopathies has been shown. Beta blockers – metoprolol and carvedilol has been tried
      useful. If the patients has disproportionate tachycardia.
    5. Carnitine Q
  2. Restrictive cardiomyopathy- uncommon, restriction to ventricular filling (Primarily diastolic dysfunction) Q
    Two types
    1. Endocardial fibrosis- Kerala
    2. Endocardial fibroelastosis-restricts systolic function as well as diastolic filling. 
  3. Hypertrophic cardiomyopathy - also known as idiopathic hypertrophic subaortic stenosis or asymmetrical septal hypertrophy Q or hypertrophic obstructive cardiomyopathy (HOCM)
    Autosomal dominant pattern of inheritance with a variable but high degree of penetrance.
    It is believed to be linked to mutation in beta myosin, Troponin T and alpha - tropomyosin gene***
    Primarily diastolic dysfunction Q 


  1. Beta blockers
  2. Morrow’s procedure Q
    Anomalous origin of left coronary artery from pulmonary artery (ALCAPA)
    One of the cause of myocardial infarction in neonate Q.
    If a patients presenting with congestive cardiomyopathy with or without a mitral regurgitation murmur shows anterolateral myocardial infarction** pattern in the ECG -indicates ALCAPA. (Deep Q wave in left precoodial leads – aVL, VSVG)
    T/t - Surgical ligation

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