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Radiology
Cardiomyopathy
Built from Obstetric Imaging
What’s inside
10 sections · 55 slides
Overview
- What is covered here
What cardiomyopathy is
A disease of the heart muscle itself
- Start with the muscle, not the plumbing
- The formal definition
- 8 / 100,000
- Why the true rate before birth is unknown
- Why diagnosis and counselling are hard
- Four forms of the same idea
Where it comes from
Secondary causes first, genes second
- Rule out the secondary causes first
- Genes explain much of the rest
- What can make a fetal heart dilate
Dilated cardiomyopathy
The commonest form before birth
- The stretched, weak heart
- Normal heart beside a dilated heart
- No two cases look alike
- From a wide chamber to a swollen fetus
- The words behind the leak
- Enlarged fetal heart with thickened muscle
- Reading that heart
- Leaking valves on colour Doppler
- Colour Doppler panel of the leaking valves
- 62-82%
Hypertrophic cardiomyopathy
Thick walls that will not relax
- The thick, stiff heart
- Thickened left ventricular wall
- A mixed bag of causes
- The fetus of a diabetic mother
- Thickened septum and ventricular walls
- M-mode tracing through the heart walls
- Two very different outlooks
- It does not stand still
Restrictive cardiomyopathy
Rarest of all, and easy to miss
- A heart that cannot fill
Noncompaction cardiomyopathy
The spongy myocardium
- A wall that never finished forming
- Two nicknames worth knowing
- Spongy heart muscle under the microscope
- Prominent trabeculations and deep recesses
- How severe can it be?
What all forms share
A stiff muscle and a falling output
- The common final pathway
- Squeeze and stretch, two separate faults
- Not always a one-way street
- Findings that warn of a worse outcome
- Why those two vein signs matter
Making the diagnosis
What the scan shows, and what to measure
- How it presents
- Ultrasound signs to hunt for
- Two measurements in a diabetic pregnancy
- What magnetic resonance imaging adds
- Classic signs
What can be done
Before birth, and afterwards
- Before birth
- The one reassuring exception
- After birth
- Before and after delivery
- What the referring physician needs to know
- Key points
- References
- References (continued)
- References (continued)
- Suggested readings
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition