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Diagnosis of Secondary Cardiomyopathy According to Endomyocardial Cardiac Biopsy

      1. Diseases with cardiac dilatation: Chronic myocarditis and cardiac sarcoidosis are diseases similar to dilated cardiomyopathy (DCM). The diagnosis of these diseases is often difficult. ⋅ Chronic myocarditis begins in a latent fashion, but then becomes chronic. Histological findings are characterized by mononuclear cell infiltrates. ⋅ Endomyocardial biopsy (EMB) has a low sensitivity in diagnosing cardiac sarcoidosis. The use of CARTO system may be able to improve the diagnostic yield of EMB. 2. Diseases with cardiac hypertrophy: ⋅ EMB is helpful to distinguish lysosomal diseases (Fabry disease and glycogen storage disease), mitochondrial diseases and cardiac amyloidosis from hypertrophic cardiomyopathy. ⋅ Vacuolization in samples of EMB is a finding suggestive of lysosomal and mitochondrial diseases. Enzyme replacement therapy is used for the treatment of Fabry disease and Pomp disease. ⋅ As for diagnosis of cardiac amyloidosis, it is important to classify the type of amyloidosis. Drug therapy using tafamidis is considered for treatment of hereditary ATTTR amyloidosis.
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