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Sinagra G, Merlo M, Pinamonti B, editors. Dilated Cardiomyopathy: From Genetics to Clinical Management [Internet]. Cham (CH): Springer; 2019. doi: 10.1007/978-3-030-13864-6_7

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Dilated Cardiomyopathy: From Genetics to Clinical Management [Internet].

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Table 7.2

Echocardiographic clues in differential diagnosis of DCM

Echocardiographic featuresPossible differential diagnosis vs. DCM
Associated significant LV hypertrophy1. Advanced hypertrophic cardiomyopathy
2. Advanced infiltrative/storage cardiomyopathy
3. Advanced hypertensive heart disease
Segmental wall motion abnormalities with coronary artery distributionIschemic cardiomyopathy
Biphasic response in at least two LV segments and/or extensive ischemic response during high-dose dobutamine or exercise stressIschemic cardiomyopathy
Wall motion abnormalities with non-coronary distribution/idiopathic LV aneurysms1. Left-dominant or biventricular AC
2. Myocarditis
3. Cardiac sarcoidosis
Prevalent RV dilation and dysfunction1. Arrhythmogenic RV cardiomyopathy with biventricular involvement
2. Congenital heart disease
3. Pulmonary hypertension
Presence of RV/LV aneurysmsAC
Low-gradient aortic valve stenosis + LV dysfunctionTrue severe aortic valve stenosis vs. pseudo-severe aortic stenosis + DCM > differentiation by response to DSE
Significant MR + LV dysfunctionFunctional MR+DCM vs. organic MR + secondary LV dysfunction > through transthoracic + transesophageal echocardiography assessment of MV
LV dysfunction without severe dilation, LV hypertrophy, non-coronary wall motion abnormalities, LV thrombiMyocarditis
Reversibility of pathological echocardiographic parameters once the causal factors are removedOther cardiomyopathies: inflammatory, alcoholic, tachycardia-induced, stress-induced, chemotherapy-induced, peripartum
Mild/moderate LV systolic dysfunction without significant dilation + severe diastolic dysfunctionMildly dilated cardiomyopathy vs. restrictive cardiomyopathy

AC arrhythmogenic cardiomyopathy, DCM dilated cardiomyopathy, DSE dobutamine stress echocardiography, LV left ventricular, MV mitral valve, MR mitral regurgitation, RV right ventricular

From: Chapter 7, Role of Cardiac Imaging: Echocardiography

Copyright 2019, The Author(s)

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