Initial Evaluation of Cardiomyopathy | |||
Clinical Evaluation | |||
Thorough history and physical examination to identify cardiac and noncardiac disordersa Detailed family history of heart failure, cardiomyopathy, skeletal myopathy, conduction disorders and tachyarrhythmias, sudden death History of alcohol, illicit drugs, chemotherapy, or radiation therapya Assessment of ability to perform routine and desired activitiesa Assessment of volume status, orthostatic blood pressure, body mass indexa | |||
Laboratory Evaluation | |||
Electrocardiograma
Chest radiographa Two-dimensional and Doppler echocardiograma Magnetic resonance imaging to assess myocardial inflammation and fibrosis Chemistry: Serum sodium,a potassium,a calcium,a magnesiuma Fasting glucose (glycohemoglobin in diabetes mellitus) Creatinine,a blood urea nitrogena Albumin,a total protein,a liver function testsa Lipid profile Thyroid-stimulating hormonea Serum iron, transferrin saturation Urinalysis Creatine kinase isoforms Cardiac troponin Hematology: Hemoglobin/hematocrita White blood cell count with differential,a including eosinophils Erythrocyte sedimentation rate | |||
Initial Evaluation When Specific Diagnoses Are Suspected | |||
DNA sequencing for genetic disease; panel selection based on phenotype Titers for infection in presence of clinical suspicion: Acute viral (e.g., coxsackievirus, echovirus, influenza) Human immunodeficiency virus Chagas' disease, Lyme disease, toxoplasmosis Coronary angiography in pts with angina who are candidates for interventiona Serologies for active rheumatologic disease Endomyocardial biopsy including sample for electron microscopy when suspecting specific diagnosis with therapeutic implications Screening for sleep-disordered breathing |
a Level I Recommendations from ACC/AHA Practice Guidelines for Chronic Heart Failure in the adult.