Presentation with Symptomatic Cardiomyopathy
| Dilated | Restrictive | Hypertrophic | |
|---|---|---|---|
| Ejection fraction (normal >55%) | Usually <30% when symptoms severe | 25-50% | >60% |
| Left ventricular diastolic dimension (normal <55 mm) | ≥60 mm | <60 mm (may be decreased) | Often decreased |
| Left ventricular wall thickness | Normal or decreased | Normal or increased | Markedly increased |
| Atrial size | Increased | Increased; may be massive | Increased |
| Valvular regurgitation | Related to annular dilation | Related to endocardial involvement; frequent mitral and tricuspid regurgitation, rarely severe | Related to valve-septum interaction; mitral regurgitation |
| Common first symptoms | Exertional intolerance | Exertional intolerance, fluid retention early | Exertional intolerance; may have chest pain |
| Congestive symptomsa | Left before right, except right prominent in young adults | Right often dominates | Left-sided congestion may develop late |
| Arrhythmia | Ventricular tachyarrhythmia; conduction block in Chagas' disease, and some families. Atrial fibrillation. | Ventricular uncommon except in sarcoidosis conduction block in sarcoidosis and amyloidosis. Atrial fibrillation. | Ventricular tachyarrhythmias; atrial fibrillation |
aLeft-sided symptoms of pulmonary congestion: dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea. Right-sided symptoms of systemic versus congestion: discomfort on bending, hepatic and abdominal distention, peripheral edema.