Disease of myocardium. Several aetiology- no need for knowing them

1. DILATED CMP
   1. AET: Viruses, Etoh, Ischaemia
   2. Systolic CHF ie triad of DOE, Oorth, PND with crackles and pulm edema
   3. Dx: Echo- dilated ventricles with poor contractility
   4. CHF: BB, ACE, DU, stop aet, Transplant
2. HOCM
   1. Echo- asymmetric septal wall thickening causing ventricular outlet obstruction
   2. Aat: Generitcs, sarcomeeres. Mummurs of AS in young athletes with DOE, Syncope, Sudden cardiac death family hx
   3. Rx: Avoid dehydration, cant exercise, BB and CCB (verapamil and ditiazem), Alcohol ablation or Myoectomy. AICD, eventually transplant
   4. F/U: Screen first degree relatives
3. Concentric hypertrophy
   1. Path: HTN
   2. Diastolic CHF
   3. Rx: Samilar to HOCM- avoid dehydration, BB=CCB, Transplant
4. RESTRICTIVE
   1. Amyloid, sarcoid, haemochromatosis, cancers, fibroisis
   2. Diastolic CF
   3. Echo: Restrictive pattern
   4. Aet workup: Neuropathy?- Amyloidosis. Pulmonary disease-> Sarcoidosis. Cirrhosis or DM ->haemochromatosis.
   5. If suspect
      1. amyloidosis- confirm with fat bad biopsy.
      2. sarcoidosis: cardiac MRI and endomyocardial biopsy
      3. Haemochromatosis: Ferritin elevated, genetics
   6. Rx: Rx DIA CHF. BB=CCB. Gentle diuresis. Transplant. Rx underlying dx