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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Daniel Lee Kulick, MD, FACC, FSCAI

Daniel Lee Kulick, MD, FACC, FSCAI

Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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The diagnosis of cardiomyopathy begins with history. Usually, the patient's symptoms consist of complaining of fatigue, weakness, and shortness of breath. There also may be chest discomfort. Other information may be gathered from past medical history including history of high blood pressure, high cholesterol, and diabetes. Noting the presence of other underlying illnesses such as sarcoidosis, amyloidosis, thyroid disorders, and rheumatoid arthritis can be helpful in determining potential causes of cardiomyopathy.

Social history including smoking, alcohol, and drug abuse can also be helpful in making the diagnosis. Family history is often important, especially if there is concern about sudden cardiac death at an early age.

Physical examination often will include monitoring vital signs including heart rate, blood pressure, respiratory rate, and oxygen saturation. The health care practitioner may obtain significant information from lung examination listening for fluid and from listening to the heart sounds. Murmurs may provide information about leaking heart valves. Examination of the jugular veins in the neck and swelling or fluid in the feet and ankles can be clues to the diagnosis of heart failure.

Blood tests may be helpful in screening for anemia, abnormalities in electrolytes, and kidney and liver function. Other blood tests and lab work may be ordered depending upon the clinical situation.

An electrocardiogram (EKG) is a screening test to look for electrical abnormalities in the heart. Evidence of previous heart attack or ventricular hypertrophy (heart muscle thickening) can be noted on the EKG.

An ultrasound of the heart (echocardiogram) can help evaluate wall motion function of the heart, the integrity of the heart valves, and the ventricle ejection fraction. It may also provide visualization of the sac (pericardium) that surrounds the heart.

Chest X-ray may reveal an enlarged or abnormal heart shape or excess fluid accumulation within the lungs.

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