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Content Update: Chagas Disease July 2023

American trypanosomiasis, or Chagas disease, is endemic in Latin America. As a result of globalization, urbanization, and migration, the disease is now seen worldwide and affects more than 6 million individuals. Pathophysiology, clinical features, and treatment are discussed in the section ‘Chagas Cardiomyopathy,’ below.

Content Update: Stress Cardiomyopathy and Takotsubo Syndrome February 2021

Stress cardiomyopathy and its commonest form, Takotsubo syndrome, is acute and transient left ventricular systolic and diastolic dysfunction after a stressful emotional or physical event. Common presenting symptoms are chest pain, dyspnea, and dizziness. ECG abnormalities can mimic STEMI. Diagnosis is confirmed by echocardiography and by lack of culprit vessel involvement on coronary arteriography. See full discussion below under the section 'Cardiomyopathies with Systolic and Diastolic Dysfunction.'

The term cardiomyopathy describes a heterogeneous group of diseases that directly alter cardiac structure, impair myocardial function, or alter myocardial electrical properties. Discoveries in molecular genetics and the description of (ion) channelopathies as diseases have prompted periodic revisions of definitions and classifications of cardiomyopathies. The MOGE(S) classification is the most recently proposed and describes the morphofunctional phenotype (M), organ(s) involvement (O), genetic inheritance pattern (G), etiology (E; which includes genetic defect or underlying disease), and functional status (S).1,2 In simple terms, primary cardiomyopathies are diseases that solely or predominantly involve the myocardium and are usually familial in origin; the most common disorders are listed in Table 55-1. Secondary cardiomyopathies include heart muscle diseases associated with specific systemic disorders. Secondary cardiomyopathies often present with morphofunctional phenotypes and hemodynamic findings similar to those of the dilated or restrictive forms of cardiomyopathy. The most common causes of secondary cardiomyopathies are listed in Table 55-2. As a group, cardiomyopathies are the third most common form of cardiac disease encountered in the United States, following coronary (ischemic) heart disease and hypertensive heart disease. Hypertrophic cardiomyopathy is the second most common cause of sudden cardiac death in the adolescent population and the leading cause of sudden death in competitive athletes.3

TABLE 55-1The Primary Cardiomyopathies
TABLE 55-2Common Causes of Secondary Cardiomyopathies

An in-depth discussion of each of the primary ...

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