[Congestive cardiomyopathy].

Abstract

Idiopathic congestive cardiomyopathy, which is often the result of a silent viral myocarditis, will occur in about 400 patients per year in Belgium. However, a comparable clinical and paraclinical picture, characterized by dilatation of the cardiac chambers and diffuse and profound hypocontractility of the myocardium, can be the common consequence of a large number of cardiac diseases. In front of a clinical presentation of heart failure, the physician will aim to identify the global myocardial insult and to rule out etiologies which, corrected, do not necessarily produce irreversible myocardial damage. This differential diagnosis will be based on medical history, physical examination, echocardiography and coronary angiography. Prognosis of congestive cardiomyopathy, although generally poor, can be greatly improved by a rational pharmacological therapy as well as new interventions (implantable defibrillator, cardiac transplantation) whose correct indications rely on technological advances and a better knowledge of the natural history of the disease.