1. Heart -Pathology
 Types 
Myocardial diseases
Cardiomypathies
Dilated (DCM), Hypertrophic (HCM), Restrictive (RCM)
Feature
DCM
HCM
RCM
Cause
Idiopathic in most
( 1/3 –Genetic),
alcohol, viral, vit.
B1 deficiency
Genetic mutations
in myocyte proteins
in All cases ( MCbeta myosin chain
mutations)
Rx related
( radiation) and
infiltrative disorders
( amyloidosis,
Metastasis, storage
diseases, Sarcoidosis)
Dysfunction
Systolic
Diastolic
Diastolic
Ejection fraction
(normal 60%)
<25%
-
-
Chambers
enlarged
All four
Lt. atrium
Both atria
1
Dr. Krishna Tadepalli, MD, www.mletips.com

2. CARDIOMYOPATHY
Dilated Cardiomyopathy
–
Mural thrombi
Globoid shape ( inferior
part
of heart rounded shape )
 Hypertrophy < dilatation
( increased, normal, or
decreased thickness)

Hypertrophic
Cardiomyopathy –
Massive
hypertrophy
in septum and free
wall of ventricle
Impaired diastolic
filling
Dilation of atrium
Restrictive
Cardiomyopathy
ventricle walls stiff (not
dilated)
Both atria are dilated
Impaired diastolic
filling
2
Dr. Krishna Tadepalli, MD, www.mletips.com

3. Heart -Pathology
Myocardial diseases
 Dilated (DCM) globoid heart
 Hypertrophic (HCM) hypertrophic inter ventricular
septum (3 times thicker than left ventricular wall -3:1), banana
shaped septum
 Myocyte disarray, fibrosis
 What is normal septal to ventricular wall thickness ratio?
Which Cardiomyopathy?
3
Dr. Krishna Tadepalli, MD, www.mletips.com

4. Heart -Pathology
Myocardial diseases
 Myocarditis
 Causes
  viral ( MC in North America – Coxsackie B)
 Trypanosoma cruzi – (MC in South America)
 Hypersensitivity  drugs
 Giant cell Idiopathic
 Clinical  nonspecific( Flu like – fever, Dyspnea), pain,
palpitations
 Types
4
Dr. Krishna Tadepalli, MD, www.mletips.com

5. Heart -Pathology
Myocarditis
 Types
Feature
Lymphocytic Chaga’s
(Viral)
Giant cell
Hypersensitivity
Cause
Viral (Coxsackie
B)
Trypanosoma
Idiopathic
Drugs
( antibiotics, anti
–HTN)
Geography
North America
South America
-
-
Cell response
Lymphocytes
Necrosis
+PMN
+organisms
Giant cells,
PMN,
Eosiophils
Prognosis
-
-
Poor
5
Dr. Krishna Tadepalli, MD, www.mletips.com

6. Myocarditis - Types
6
Dr. Krishna Tadepalli, MD, www.mletips.com

7. Myocarditis - Types
6
Dr. Krishna Tadepalli, MD, www.mletips.com