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Echocardiographic recognition of cardiomyopathies

Nelson B Schiller, MD, FACC, FRCP, FASE
Xiushui Ren, MD
Bryan Ristow, MD, FACC, FASE, FACP
Section Editor
Warren J Manning, MD
Deputy Editor
Susan B Yeon, MD, JD, FACC


Cardiomyopathy is defined as a disease of heart muscle. Cardiomyopathies include a variety of myocardial disorders that manifest with various structural and functional phenotypes with familial and nonfamilial types. This topic will review the echocardiographic features of the various types of cardiomyopathy. The general evaluation of the patient with heart failure or cardiomyopathy is discussed separately. (See "Determining the etiology and severity of heart failure or cardiomyopathy".)


The classification of cardiomyopathies is reviewed separately. In summary, morphological and functional attributes have been described by the 2006 American Heart Association and 2008 European Society of Cardiology classification systems (table 1A-B) [1,2]. Heart disease secondary to coronary artery, valvular, or congenital heart disease is excluded from the cardiomyopathy classification. However, in clinical practice, the terms “ischemic,” “valvular,” and “hypertensive cardiomyopathy” have been used commonly. There are five types of cardiomyopathy that are each recognized by echocardiography [1,2]. In the MOGE(S) classification endorsed by the World Heart Federation, cardiomyopathy is categorized by the following characteristics: morphofunctional (M), organ involvement (O), genetic or familial inheritance (G), etiological annotation (E), and stage (S) [3]. (See "Definition and classification of the cardiomyopathies".)

The five types of morphofunctional cardiomyopathy are as follows (table 1A-B) [2]:

Dilated cardiomyopathy arising as primary myocardial disease of unknown etiology or as disorders of toxic, familial, or infective origin. In clinical practice, ischemic cardiomyopathy is frequently viewed as a type of dilated cardiomyopathy, although current major society classification systems exclude it [1,2]. (See "Causes of dilated cardiomyopathy" and "Familial dilated cardiomyopathy: Prevalence, diagnosis and treatment".)  

Hypertrophic cardiomyopathy, including various causes of increased left ventricular wall thickness not caused by hypertension or valve disease. (See "Hypertrophic cardiomyopathy: Clinical manifestations, diagnosis, and evaluation".) Restrictive cardiomyopathy, including cardiac amyloidosis and endomyocardial fibrosis. (See "Idiopathic restrictive cardiomyopathy" and "Clinical manifestations and diagnosis of amyloid cardiomyopathy" and "Endomyocardial fibrosis".)

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Literature review current through: Nov 2017. | This topic last updated: Dec 22, 2016.
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