Ultrasound Features of Cardiomyopathy

Cardiomyopathy refers to a group of heart muscle disorders that affect the heart's ability to pump blood effectively. Ultrasound imaging, particularly echocardiography, plays a crucial role in diagnosing and characterizing different types of cardiomyopathy. Below are the most common echocardiographic findings associated with the main types of cardiomyopathy.

Dilated Cardiomyopathy

Dilated cardiomyopathy (DCM) is one of the most commonly diagnosed forms of cardiomyopathy. On echocardiography, it typically presents with dilation of one or both ventricles, along with enlargement of the atria. The left ventricular wall, especially the interventricular septum, shows significantly reduced motion, indicating impaired systolic function. Patients often experience symptoms such as fatigue, weakness, and chest discomfort due to left-sided heart failure. In more advanced cases, fluid retention and shortness of breath may also occur, especially during physical activity.

Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is characterized by abnormal thickening of the left ventricular myocardium. This thickening can be either uniform or localized, most commonly affecting the interventricular septum. Echocardiography reveals reduced motion in the septum while other areas of the left ventricular wall may exhibit increased contractility. Clinically, patients may present with exertional dyspnea, angina-like chest pain, or even syncope due to obstruction of blood flow or arrhythmias. HCM is also a known cause of sudden cardiac death, especially in young athletes, making early diagnosis through ultrasound imaging essential.

Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is less common but equally serious. Echocardiographic findings typically include heterogeneous myocardial echoes, often described as granular or speckled patterns, indicating fibrosis or infiltration of the heart muscle. The left ventricular cavity may appear normal in size or slightly reduced in diameter. Patients often suffer from symptoms such as chest pain, arrhythmias, and signs of heart failure, including peripheral edema and fatigue. Due to its similarity in presentation with other cardiac conditions like constrictive pericarditis, echocardiography must be carefully interpreted to differentiate RCM from other pathologies.