Secondary cardiomyopathy: patterns and underlying causes
THE CONTEXT
Systemic diseases and toxic exposures can cause heart muscle disease resembling different cardiomyopathy patterns. Treatment and prognosis depend on the underlying disorder.
Patterns of cardiac involvement
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Connective tissue disorders, sarcoidosis, haemochromatosis and alcoholic heart muscle disease can produce a picture indistinguishable from dilated cardiomyopathy.
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Amyloidosis and eosinophilic heart disease produce symptoms and signs resembling restrictive or obliterative cardiomyopathy.
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Heart disease associated with Friedreich ataxia can mimic hypertrophic cardiomyopathy.
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Abstention from alcohol may produce dramatic improvement in alcoholic heart muscle disease.
Infectious causes
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Listed viral causes are Coxsackie A and B, influenza, HIV and SARS-CoV-2.
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Listed bacterial causes are diphtheria and Borrelia burgdorferi.
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Listed protozoal causes are trypanosomiasis and Toxoplasma gondii.
Endocrine, metabolic and connective tissue disorders
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Endocrine and metabolic causes include diabetes, hypothyroidism, hyperthyroidism, acromegaly, carcinoid syndrome, phaeochromocytoma and inherited storage diseases.
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Connective tissue diseases include systemic sclerosis, systemic lupus erythematosus and polyarteritis nodosa.
Infiltrative, toxic and neuromuscular causes
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Infiltrative disorders include haemochromatosis, haemosiderosis, sarcoidosis and amyloidosis.
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Listed toxins and exposures are doxorubicin, alcohol, cocaine and irradiation.
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Neuromuscular disorders include dystrophia myotonica and Friedreich ataxia.