Cardiomyopathy is a primary disorder of the heart muscle. It differs from structural heart disease such. As coronary artery disease, valvular heart disease and congenital heart defects. Cardiomyopathies are divided according to their pathological features in three main types: (s forms of cardiomyopathy.) Dilated hypertrophic Restrictive The term ischemic cardiomyopathy refers to the advanced, poorly contracting heart that can occur in patients with severe coronary artery disease (with or without infarction areas) , Although he does not describe a primary myocardial disease, the term is still in use. The manifestations of cardiomyopathies are usually the ones of heart failure; Depending on whether a systolic dysfunction, diastolic dysfunction, or both is present vary (heart failure: pathophysiology). Some cardiomyopathies can lead to chest pain, syncope or sudden death. The evaluation typically requires blood testing, EKG, chest X-ray, echocardiography and often an MRI, if available. Some patients require endomyocardial biopsy (transvenous right ventricular or retrograde left ventricle). To determine the cause further investigation may be required. Treatment depends on the specific type and cause of cardiomyopathy from (s. Diagnosis and treatment of cardiomyopathies). Forms of cardiomyopathy diagnosis and treatment of cardiomyopathies property or method dilated hypertrophic Restrictive Pathophysiology Systolic Diastolic dysfunction dysfunction ± obstruction of the outflow tract Diastolic dysfunction Clinical findings Limited LV and RV function cardiomegaly Functional AV valve regurgitation S3 and / or S4 exertional dyspnea, angina, syncope, sudden death systolic murmur ± mitral regurgitation murmur, S4 Divided carotid pulse with a rapid charge and rapid descent of exertional dyspnea and fatigue LV ± RV dysfunction Functional AV valve regurgitation ECG Nonspecific ST and T-wave abnormalities Q waves ± branch block LV hypertrophy and ischemia depth septal Q waves LV hypertrophy or low voltage QRS Echocardiography Advanced hypokinetic ventricles ± mural thrombus Low EF and often functional AV valve regurgitation Hypertrophic ventricle ± systolic anterior motion of the mitral valve ± asymmetric hypertrophy ± LV gradient Increased wall thickness ± Herzhöhlenobliterierung diastolic LV dysfunction X cardiomegaly pulmonary venous congestion No cardiomegaly No or mild cardiomegaly hemodynamics normal or high enddiastolis cher pressure, EF low, diffuse advanced hypokinetic ventricle ± AV valve regurgitation Low cardiac output High end-diastolic pressure, high EF ± subvalvular outflow tract gradient ± Mitralinsuffizienz Normal or low cardiac output High end-diastolic pressure, Dip plateau phenomenon of diastolic LV pressure curve Normal or low cardiac prognosis 20% mortality in the first year, followed by about 10% / year, about 1% annual risk of sudden cardiac death 70% 5-year mortality treatment of diuretics, ACE inhibitors, angiotensin II receptor blockers, ?-blockers, spironolactone or eplerenone, digoxin, ICD, cardiac resynchronization therapy, anticoagulants ?-blocker verapamil ± ± ± disopyramide septal Myectomy ± alcohol ablation; AV stimulation phlebotomy for hemochromatosis Endocardial resection hydroxyurea for hypereosinophilic AV = atrioventricular; BBB = bundle branch block; CO = heart-minute volume; EDP ??= end-diastolic pressure; EF = ejection fraction; ICD = implantable cardioverter defibrillator; LV = left ventricular; RV = right ventricular; S3 = 3. Heartbeat; S4 = 4. heart sound; ± = with or without.