Cardiomyopathy causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

There is a very wide range of factors that can cause cardiomyopathy, ranging from infectious causes, toxins, genetic causes and other disease processes.

Causes

Common Causes

• Alcoholism

• Amyloidosis

• Anthracyclines

• Beri-Beri (thiamine or vitamin B1)

• Chagas disease

• Cocaine abuse

• Coxsackie virus

• Cushing's Disease
• Chronic tachycardia

• Diabetes Mellitus

• Electrolyte imbalance

• Hypertrophic obstructive cardiomyopathy
• Hypothyroidism

• HIV

• Idiopathic dilated cardiomyopathy
• Kwashiorkor

• Peripartum cardiomyopathy
• Stress cardiomyopathy

Causes by Organ System

Cardiovascular	Arrhythmogenic right ventricular dysplasia, arterial calcification of infancy, Brugada syndrome, cardiac transplant rejection, cardiomyopathy with myopathy due to COX deficiency, cardiomyopathy-diabetes-deafness complex, cardiomyopathy-hypogonadism-metabolic anomalies complex, cardiomyopathy-renal anomalies, chronic tachycardia, coronary artery disease, endomyocardial fibrosis, eosinophilic endomyocardial disease, facio-cardio-musculo-skeletal syndrome, giant cell myocarditis, hypertension, Keshan disease, left ventricular noncompaction, Loeffler endocarditis, myocarditis, Naxos disease, obesity-colitis-hypothyroidism-cardiac hypertrophy-developmental delay, prolonged QT syndrome, x-linked dilated cardiomyopathy, x-linked fatal infantile cardiomyopathy
Chemical / poisoning	Arsenic, cobalt, endothall, ethanol, lead, thallium
Dermatologic	Familial cutaneous collagenoma, Lentiginosis, Dermatomyositis
Drug Side Effect	Aclarubicin, Anthracyclines, Bleomycin, Clozapine, Cyclophosphamide, Doxorubicin, Idarubicin, Mitoxantrone, Paracetamol, Peplomycin, Tacrolimus, Tricyclic anti-depressant abuse
Ear Nose Throat	No underlying causes
Endocrine	Acromegaly, Cushing's Disease, Diabetes Mellitus, Hyperparathyroidism, Hyperthyroidism, Hypothyroidism, Pheochromocytoma, Pituitary tumor (growth hormone secreting), Cardiomyopathy - diabetes - deafness, Cardiomyopathy -- hypogonadism -- metabolic anomalies complex, Obesity -- colitis -- hypothyroidism -- cardiac hypertrophy -- developmental delay, Carcinoid syndrome
Environmental	Heatstroke, Hypothermia, Lightening strike
Gastroenterologic	Hemochromatosis, Hepatitis, Obesity -- colitis -- hypothyroidism -- cardiac hypertrophy -- developmental delay complex, Whipple's Disease
Genetic	Alpers Syndrome, Familial cardiomyopathy, Hutchinson-Gilford progeria syndrome, Noonan syndrome, Sarcoglycanopathy, X-linked - fatal infantile Cardiomyopathy, Friedrich's Ataxia, Brugada syndrome
Hematologic	Cardiomyopathy -- spherocytosis
Iatrogenic	No underlying causes
Infectious Disease	Bacteria: Beta-hemolytic streptococci, Borrelia burgdorferi, Brucella, Diptheria, Enterococci , Leptospirosis, Lyme Disease, Pertussis, Psittacosis, Q Fever, Rocky Mountain Spotted Fever, Staphylococcus, Syphilis, Tetanus, Tuberculosis, Typhoid Fever, Rheumatic Fever Virus: Adenovirus, Arbovirus, Coxsackie virus A, Coxsackie virus B1-B5, Cytomegalovirus (CMV), ECHO virus (EnteroCytopathogenic Human Orphan viruses), Epstein-Barr Virus (EBV), Flavivirus, HIV, Influenza, Measles, Mumps,Oral candidiasis, Polio, Rabies, Varicella-zoster virus Fungi: Aspergillosis, Blastomycosis, Coccidioidomycosis, Cryptococcosis, Histoplasmosis Parasites: African Sleeping sickness, Amebiasis, Ascariasis, Chagas disease, Cysticercosis, Filariasis, Leishmaniasis, Loeffler endocarditis, Malaria, Sarcosporidiosis, Schistosomiasis, Toxoplasmosis, Trichinosis
Musculoskeletal / Ortho	Dermatomyositis, Arthrogryposis due to muscular dystrophy, Duchenne muscular dystrophy, Emery-Dreifuss muscular dystrophy, Limb girdle muscular dystrophy, Mitochondrial myopathy, Muscular Dystrophy, Myotonic dystrophy, Recessive type Metaphyseal chondrodysplasia, Kearns-Sayre Syndrome, Cardiomyopathy with myopathy due to COX deficency, Facio-cardio-musculo-skeletal syndrome, Hand-Schuller-Christian Syndrome
Neurologic	Friedrich's Ataxia, Kearns-Sayre Syndrome, Whipple's Disease, Alpers Syndrome, Hand-Schuller-Christian Syndrome, MELAS
Nutritional / Metabolic	3-methylglutaconic aciduria type 4, Beri-Beri (thiamine or vitamin B1), Carbohydrate deficient glycoprotein syndrome type 1a, Carnitine deficiency, Carnitine palmitoyltransferase 2 deficiency, Carnitine transporter deficiency, Coenzyme Q 10 (CoQ10) deficiency, Coenzyme Q cytochrome c reductase deficiency, Congenital disorder of glycosylation, Cytochrome C Oxidase deficiency, Fabry's Disease, Gangliosidosis, Gaucher's Disease, Glutaric acidemia type 2, Glycogen storage diseases, Gout, Hunter's Syndrome, Hurler's Syndrome, Keshan disease, Kwashiorkor, Malonic aciduria, MELAS, Neimann-Pick Disease, Niacin deficiency, Oxalosis, Porphyria, Refsum's disease, scurvy, Triosephosphate isomerase deficiency, Vitamin B deficiency, Vitamin D overdose , Hemochromatosis
Obstetric/Gynecologic	Peripartum cardiomyopathy
Oncologic	Angioma, Myxomas, Pituitary tumour (growth hormone secreting), Rhabdomyoma, Sarcoma, Leukemia, WAGR Syndrome, Carcinoid syndrome
Opthalmologic	Hand-Schuller-Christian Syndrome, Microphthalmia, syndromic 7, Myotonic dystrophy, WAGR Syndrome
Overdose / Toxicity	No underlying causes
Psychiatric	Takotsubo cardiomyopathy
Pulmonary	No underlying causes
Renal / Electrolyte	Electrolyte imbalance, Hypocalcemia, Hypokalemia, Hypomagnesemia, Uremia, WAGR Syndrome, MELAS
Rheum / Immune / Allergy	Polyarteritis nodosa, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Systemic Lupus Erythematosus, Kawasaki's Disease, Gout
Sexual	No underlying causes
Trauma	Trauma
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Cocaine abuse, Alcoholism, Amyloidosis, Electric shock, Idiopathic dilated cardiomyopathy, Immunoglobulinic amyloidosis, Irradiation, Mitochondrial trifunctional protein deficiency, Obesity, physically and physiologically stress induced (tako-tsubo syndrome or "broken heart syndrome"), Toxic mushrooms -- cyclopeptides

Causes in Alphabetical Order

• 1p36 deletion syndrome
• 3-hydroxyacyl-CoA dehydrogenase deficiency
• 3-methylglutaconic aciduria type 4
• 5-fluorouracil
• Aclarubicin
• Acromegaly
• Actinomycin D
• Adenovirus
• African trypanosomiasis
• Alcohol
• Alemtuzumab
• Allylamine
• Alpers' syndrome
• Alström syndrome
• Amrubicin
• Amyloidosis
• Arboviruses
• Arrhythmogenic right ventricular cardiomyopathy
• Arsenic
• Arterial calcification of infancy
• Arthritis--short stature--deafness syndrome
• Arthrogryposis due to muscular dystrophy
• Asbestosis
• Ascariasis
• Aspergillosis
• Autosomal recessive progressive external ophthalmoplegia
• Barth syndrome
• Beriberi (vitamin B1 deficiency)
• Beta-hemolytic streptococci
• Black widow spiders
• Blastomycosis
• Bleomycin
• Borrelia burgdorferi (Lyme disease)
• Borud syndrome
• Brucella
• Brugada syndrome
• Carbohydrate deficient glycoprotein syndrome type 1a
• Carbon monoxide toxicity
• Carcinoid syndrome
• Cardiac irradiation
• Cardiac transplant rejection
• Cardiofaciocutaneous syndrome (CFC)
• Cardiomyopathy with myopathy due to COX deficency
• Cardiomyopathy--diabetes--deafness complex
• Cardiomyopathy--hypogonadism--metabolic anomalies complex
• Cardiomyopathy--renal anomalies disease
• Carnitine deficiency
• Carvajal-Huerta syndrome
• Celiac disease
• Certolizumab pegol
• Chagas disease
• Chorea-acanthocytosis
• Chromosome 11, partial deletion
• Chronic tachycardia
• Cisplatin
• Clozapine
• Cobalt
• Cobalt poisoning
• Cocaine abuse
• Coccidioidomycosis
• Coenzyme Q cytochrome c reductase deficiency
• Coenzyme Q10 (CoQ10) deficiency
• Congenital disorders of glycosylation type 1a
• Congenital generalized lipodystrophy type 2
• Coronary artery disease
• Costello syndrome
• Coxsackie A virus
• Coxsackieviruses B1 and B5
• Cryptococcosis
• Cushing syndrome
• Cyclophosphamide
• Cysticercosis
• Cytochrome c oxidase deficiency
• Cytomegalovirus
• D-2-hydroxyglutarate dehydrogenase deficiency
• Dasatinib
• Daunorubicin
• Dermatomyositis
• Desmin myopathy

• Diabetes mellitus
• Diptheria
• Disopyramide
• Doxorubicin
• Echovirus
• Emery-dreifuss muscular dystrophy
• End-stage renal disease
• Endocardial fibroelastosis
• Endomyocardial fibrosis
• Endothall poisoning
• Enterococci
• Epirubicin
• Epstein-Barr virus
• Fabry disease
• Facio-cardio-musculo-skeletal syndrome
• Familial cardiomyopathy
• Familial cutaneous collagenoma
• Familial hypertrophic cardiomyopathy
• Fatty acid oxidation disorders
• Fatty infiltration of the heart
• Fenfluramine
• Filariasis
• Flavivirus
• Friedreich's ataxia
• Gangliosidosis
• Gaucher's disease
• Giant cell myocarditis
• Glutaric acidemia type 2
• Glycogen storage diseases
• Gout
• Hand-Schuller-Christian syndrome
• Heatstroke
• Hemochromatosis
• Hereditary spherocytosis
• Histoplasmosis
• HIV infection
• Hunter syndrome
• Hurler syndrome
• Hutchinson-Gilford progeria syndrome
• Hydralazine
• Hypereosinophilic syndrome
• Hyperparathyroidism
• Hypertension
• Hyperthyroidism
• Hypertrichotic osteochondrodysplasia (Cantu syndrome)
• Hypocalcemia
• Hypokalemia
• Hypomagnesemia
• Hypothermia
• Hypothyroidism
• Idarubicin
• Idiopathic dilated cardiomyopathy
• Imatinib
• Inflammatory myocarditis
• Influenza
• Interferon-alfa
• Isobutyryl-CoA dehydrogenase deficiency
• Kawasaki disease
• Kearns-Sayre syndrome
• Keshan disease
• Kwashiorkor
• Laing distal myopathy
• LAMA2-related muscular dystrophy
• Lead
• Left ventricular noncompaction
• Leishmaniasis
• Leptospirosis
• Leukemia
• Lightning strike
• Loa loa
• Loeffler endocarditis
• Long-chain Acyl Coa dehydrogenase deficiency
• Malaria
• Malonic aciduria
• Malonyl-Coa decarboxylase deficiency
• McLeod syndrome
• Measles
• MELAS syndrome
• Metaphyseal chondrodysplasia, recessive type
• Metastatic cancers
• Mitochondrial trifunctional protein deficiency
• Mitoxantrone

• Mucopolysaccharidoses
• Multiple lentigines syndrome
• Mumps
• Muscular dystrophy
• Myocarditis
• Myxomas
• Naxos disease
• Niacin deficiency
• Niemann-Pick disease
• Noonan syndrome
• Obesity--colitis--hypothyroidism-cardiac hypertrophy--developmental delay
• Obstructive sleep apnea
• Oxalosis
• Paclitaxel
• Paracetamol
• Paraneoplastic syndromes
• Peplomycin
• Peripartum cardiomyopathy
• Pertussis
• Pheochromocytoma
• Pirarubicin
• Pityriasis lichenoides et varioliformis acuta (PLEVA)
• Pixantrone
• Poliomyelitis
• Polyarteritis nodosa
• Polycythemia vera
• Pompe disease
• Porphyria
• Prolonged QT syndrome
• Pseudoxanthoma elasticum
• Psittacosis
• Q-fever
• Rabies
• Radiation
• Refsum disease
• Respiratory chain complex I deficiency
• Rhabdomyoma
• Rheumatic fever
• Rheumatoid arthritis
• Rocky mountain spotted fever
• S-adenosylhomocysteine hydrolase deficiency
• Salih myopathy
• Sarcoglycanopathy
• Sarcoidosis
• Sarcomas
• Sarcosporidiosis
• Schistosomiasis
• Scurvy
• Selenium deficiency
• Sickle cell anemia
• Staphylococcus
• Streptomycin
• Stress-induced cardiomyopathy
• Subacute necrotising encephalomyelopathy (Leigh's disease)
• Sunitinib
• Syndromic microphthalmia type 7
• Syphilis
• Systemic lupus erythematosus
• Systemic sclerosis
• Tacrolimus
• Tetanus
• Thallium
• Thrombotic thrombocytopenic purpura
• Toxic mushrooms
• Toxoplasmosis
• Trastuzumab
• Trichinosis
• Tricyclic anti-depressant abuse
• Triosephosphate isomerase deficiency
• Tuberculosis
• Typhoid fever
• Uremia
• Valrubicin
• Varicella-zoster virus
• Vitamin D overdose
• WAGR syndrome
• Whipple's disease
• Wolfram syndrome
• X-linked dilated cardiomyopathy
• X-linked fatal infantile cardiomyopathy
• Yunis-Varon syndrome

Genetic Causes of Cardiomyopathy

Phenotype	Inheritance Pattern	Chromosomal Locus	Gene	Protein	Skeletal Myopathy
Dilated cardiomyopathy	X-linked	Xp21	dystrophin	Dystrophin	Duchenne / Becker muscular dystrophy
	X-linked	Xq28	G4.5	Tafazzin	Barth syndrome
	Autosomal dominant	15q14	actin	Actin	Nemaline myopathy
		2q35	desmin	Desmin	Desmin myopathy
		5q33	δ-sarcoglycan	δ-sarcoglycan	Limb girdle muscular dystrophy 2F
		1q32	Troponin T	Troponin T
		14q11	β-myosin heavy chain	β-myosin heavy chain
		15q2	α-tropomyosin	α-tropomyosin	Nemaline myopathy
		Midna	Mitochondrial respiratory chain	Mitochondrial respiratory chain	Mitochondrial myopathy
Dilated cardiomyopathy with conduction disease	Autosomal dominant	1q21	lamin A/C	Lamin A/C	Emery-Dreifuss muscular dystrophy
Hypertrophic cardiomyopathy	Autosomal dominant	14q11	β-myosin heavy chain	β-myosin heavy chain
		14q11	β-myosin heavy chain	β-myosin heavy chain
		1q32	Troponin T	Troponin T
		12q23	Troponin T	Troponin T
		15q2	α-tropomyosin	α-tropomyosin	Nemaline myopathy
		11q11	myosin-binding protein C	myosin-binding protein C
		3p21	myosin essential light chain	myosin essential light chain
		3p21	myosin regulatory light chain	myosin regulatory light chain
		2p31	titin	Titin
Hypertrophic cardiomyopathy with Wolf-Parkinson-White syndrome		7q3	AMPK	AMPK
		MIDINA	Mitochondrial respiratory chain	Mitochondrial respiratory chain	Mitochondrial myopathy
Left ventricular noncompaction	X-linked	Xq28	G4.5	Tafazzin	Barth syndrome
	Autosomal dominant	18q12	α-dystrobrevin	α-dystrobrevin	Muscular dystrophy

Table from article *"The Failing Heart". Nature. June 15, 2007