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Fig. 15-1. Flow diagram for the work-up of patients with dilated cardiomyopathy. The timing of endomyocardial biopsy in patients who fail to improve on medical therapy is controversial. If the patient's left ventricular function and symptoms are stable after 1 week of treatment, additional time before endomyo-cardial biopsy could be considered, if appropriate in the treating physician's clinical judgment, to allow for delayed recovery to occur. ECG, electrocardiography; echo, echocardiography. (From Wu LA, Lapeyre AC III, Cooper LT. Current role of endomyocardial biopsy in the management of dilated cardiomyopathy and myocarditis. Mayo Clin Proc 2001;76:1030-1038. By permission of Mayo Foundation for Medical Education and Research.)

Fig. 15-1. Flow diagram for the work-up of patients with dilated cardiomyopathy. The timing of endomyocardial biopsy in patients who fail to improve on medical therapy is controversial. If the patient's left ventricular function and symptoms are stable after 1 week of treatment, additional time before endomyo-cardial biopsy could be considered, if appropriate in the treating physician's clinical judgment, to allow for delayed recovery to occur. ECG, electrocardiography; echo, echocardiography. (From Wu LA, Lapeyre AC III, Cooper LT. Current role of endomyocardial biopsy in the management of dilated cardiomyopathy and myocarditis. Mayo Clin Proc 2001;76:1030-1038. By permission of Mayo Foundation for Medical Education and Research.)

Table 15-1

Conditions That Can Be Diagnosed by Endomyocardial Biopsy

Arrhythmogenic right ventricular dysplasia

Amyloidosis

Sarcoidosis

Hemochromatosis

Myocarditis (eg, eosinophilic myocarditis, giant cell myocarditis) Anthracycline cardiomyopathy Storage diseases such as mucopolysaccharidoses Carcinoid heart disease

Primary and metastatic neoplasms (eg, rhabdomyosarcoma, lymphoma) Radiation-induced cardiac fibrosis Cardiac allograft rejection

Table 15-2

Common Clinicopathologic Diagnoses in 1,230 Patients With Initially Unexplained Cardiomyopathy

Diagnosis Patients, no. (%)

Table 15-2

Common Clinicopathologic Diagnoses in 1,230 Patients With Initially Unexplained Cardiomyopathy

Diagnosis Patients, no. (%)

Idiopathic dilated cardiomyopathy

6l6

(5O)

Myocarditis

lll

(9)

Ischemic cardiomyopathy

9l

(7)

Infiltrative disease

0 0

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