Publication:

Evaluation of electrocardiographic and echocardiographic findings in patients with cardiomyopathy: a narrative review

Cardiomyopathies represent a heterogeneous group of myocardial diseases characterized by structural and functional alterations of the heart muscle. These conditions are a significant cause of morbidity and mortality worldwide, frequently leading to heart failure, arrhythmias, and sudden cardiac death (SCD). Electrocardiography (ECG) and echocardiography are the cornerstone diagnostic tools in the evaluation of these conditions, providing critical information about cardiac structure, function, and electrical activity. The purpose of this narrative review is to examine the most clinically significant cardiomyopathies-dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), and restrictive cardiomyopathy (RCM)-with a focus on their epidemiology, pathophysiology, and the characteristic ECG and echocardiographic findings used in diagnosis and management. Relevant literature was identified through PubMed and major cardiology guidelines up to March 2021. Search terms included: “cardiomyopathy,” “dilated cardiomyopathy,” “hypertrophic cardiomyopathy,” “restrictive cardiomyopathy,” “ECG findings cardiomyopathy,” and “echocardiography cardiomyopathy.” HCM is the most prevalent primary cardiomyopathy with an estimated prevalence of 1 in 500 persons. Dilated cardiomyopathy (DCM) has a prevalence of approximately 1 in 2,500 and is the leading indication for cardiac transplantation. Restrictive cardiomyopathy (RCM) is the rarest of the three, accounting for approximately 2-5% of cardiomyopathy cases. Each type demonstrates distinct and clinically meaningful ECG and echocardiographic patterns. Cardiomyopathies are associated with significant cardiovascular risk, and HCM in particular remains the leading cause of SCD in young athletes in the United States. Early identification using ECG and echocardiography is essential for risk stratification and management. Distinguishing physiological cardiac remodeling from pathological disease requires comprehensive diagnostic evaluation.