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What is a cardiomyopathy?
Cardiac failure is the heart’s inability to deliver sufficient blood flow for metabolic demands. Cardiomyopathy is a myocardial abnormality that may lead to cardiac failure (Table 11.1). Cardiomyopathy may result from a primary abnormality of the myocardium, or may be secondary to valvular, hypertensive, ischemic, infiltrative, structural, or pericardial disease processes. Regardless of the underlying etiology, compensatory changes (e.g., dilation and/or hypertrophy of the heart chambers) represent a final common outcome of adverse myocardial remodeling. A thorough evaluation of the patient presenting with typi-cal signs and symptoms of heart failure (e.g., fatigue, short-ness of breath, impaired exercise tolerance, peripheral edema, pulmonary rales, and renal insufficiency) is often required to establish the true underlying etiology. In addi-tion to history, physical examination and focused labora-tory testing, evaluation often requires both noninvasive and invasive modalities, including echocardiography, car-diac catheterization, and endomyocardial biopsies.
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