Chapter 117: Cardiomyopathies and Myocarditis

Thorough history and physical examination to identify cardiac and noncardiac disorders^a

Detailed family history of heart failure, cardiomyopathy, skeletal myopathy, conduction disorders and tachyarrhythmias, sudden death

History of alcohol, illicit drugs, chemotherapy, or radiation therapy^a

Assessment of ability to perform routine and desired activities^a

Assessment of volume status, orthostatic blood pressure, body mass index^a

Chest radiograph^a

Two-dimensional and Doppler echocardiogram^a

Magnetic resonance imaging to assess myocardial inflammation and fibrosis

Chemistry:

 Serum sodium,^a potassium,^a calcium,^a magnesium^a

 Fasting glucose (glycohemoglobin in diabetes mellitus)

 Creatinine,^a blood urea nitrogen^a

 Albumin,^a total protein,^a liver function tests^a

 Lipid profile

 Thyroid-stimulating hormone^a

 Serum iron, transferrin saturation

 Urinalysis

 Creatine kinase isoforms

 Cardiac troponin

Hematology:

 Hemoglobin/hematocrit^a

 White blood cell count with differential,^a including eosinophils

 Erythrocyte sedimentation rate

DNA sequencing for genetic disease; panel selection based on phenotype

Titers for infection in presence of clinical suspicion:

 Acute viral (e.g., coxsackievirus, echovirus, influenza)

 Human immunodeficiency virus

 Chagas’ disease, Lyme disease, toxoplasmosis

Coronary angiography in pts with angina who are candidates for intervention^a

Serologies for active rheumatologic disease

Endomyocardial biopsy including sample for electron microscopy when suspecting specific diagnosis with therapeutic implications

Screening for sleep-disordered breathing