0 2 3 4
A0 A2 A3 A4
Inter TH1
B0 C1 C2 C3 C4
D1 D2 D3 D4
E1 E2 E3 E4
F1 F2 F3 F4
Inter TH2
G0 G2 G3 G4

0 2 3 4
A0 A2 A3 A4
Inter TH1
B0 C1 C2 C3 C4
D1 D2 D3 D4
E1 E2 E3 E4
F1 F2 F3 F4
Inter TH2
G0 G2 G3 G4

0 A0 Inter TH1 B0 Inter TH2 G0
C1 D1 E1 F1
2 A2 C2 D2 E2 F2 G2
3 A3 C3 D3 E3 F3 G3
4 A4 C4 D4 E4 F4 G4

0 A0 Inter TH1 B0 Inter TH2 G0
C1 D1 E1 F1
2 A2 C2 D2 E2 F2 G2
3 A3 C3 D3 E3 F3 G3
4 A4 C4 D4 E4 F4 G4

1·11·21·3
2·1 - 3·22·3
3·3
4·14·24·3
1·1 2·1 - 3·2 4·1
1·2 4·2
1·3 2·3 3·3 4·3

1·11·21·3
2·1 - 2·22·3 - 3·3
3·13·2 - 4·2
4·14·3

1·1 2·1 - 2·2 3·1 4·1
1·2 3·2 - 4·2
1·3 2·3 - 3·3 4·3

Part Characteristics
Crown
  • Covered by enamel
  • Projects above the gingiva (gums)
Neck
  • Located between the crown and the root
Root
  • Located in the alveolar surface of the mandible and/or maxilla
  • Connected to the bone by the periodontal ligament (a type of modified periosteal layer)
  • Covered with cementum
  • Mandibular molars have 2 roots.
  • Maxillary molars have 3 roots.

Part Crown Neck Root
Characteristics
  • Covered by enamel
  • Projects above the gingiva (gums)
  • Located between the crown and the root
  • Located in the alveolar surface of the mandible and/or maxilla
  • Connected to the bone by the periodontal ligament (a type of modified periosteal layer)
  • Covered with cementum
  • Mandibular molars have 2 roots.
  • Maxillary molars have 3 roots.

0 2 3 4
A0 A2 A3 A4
B0 C1 C2 C3 C4
D1 D2 D3 D4
E1 E2 E3 E4
F1 F2 F3 F4
G0 G2 G3 G4

0 A0 B0 G0
C1 D1 E1 F1
2 A2 C2 D2 E2 F2 G2
3 A3 C3 D3 E3 F3 G3
4 A4 C4 D4 E4 F4 G4

Dilated cardiomyopathy

Hypertrophic cardiomyopathy

Restrictive cardiomyopathy
Etiology
  • Mostly idiopathic
  • Genetic predisposition (TTN gene mutation)
  • Ischemic heart disease
  • Infectious diseases
    • Coxsackie B virus
    • Chagas disease
    • HIV
  • Systemic disorders
    • Sarcoidosis
    • Hemochromatosis
    • Thiamine deficiency (wet beriberi)
  • Toxic substances
    • Cocaine
    • Alcohol
    • Medication (e.g., doxorubicin)
  • Peripartum cardiomyopathy
  • Inherited (autosomal dominant) mutation of:
    • Myosin binding protein C
    • β-Myosin heavy chain
  • Mostly idiopathic
  • Systemic disorders
    • Amyloidosis
    • Sarcoidosis
    • Hemochromatosis
    • Systemic sclerosis
  • Heart disease
    • Loffler endocarditis
    • Endocardial fibroelastosis
  • Post-radiation fibrosis

Pathophysiology

  • Eccentric hypertrophy of the left ventricle → ↓ ventricular contractility↓ LVEF
  • Concentric hypertrophy of the left ventricle (including the interventricular septum) ↓ ventricular relaxation ↓ diastolic filling and systolic output → ↓ myocardial and peripheral perfusion
  • Obstructive type (HOCM): left ventricular outflow tract (LVOT) obstruction and mitral regurgitation due to systolic anterior movement (SAM) of the mitral valve Interventricular septum hypertrophy in combination with mitral valve leaflet displacement towards the interventricular septum can cause severe subaortic obstruction. [#13430]
  • Proliferation of connective tissue →
    • ↓ Elasticity of cardiac tissue
    • Atrial enlargement and severe diastolic dysfunction
Distinctive clinical features
  • Signs of left heart failure and right heart failure
  • S3 gallop
  • Systolic murmur
  • Frequently asymptomatic
  • Signs of left heart failure (dyspnea, syncope, dizziness)
  • Arrhythmias
  • S4 gallop
  • Possible holosystolic murmur from mitral regurgitation
  • Sudden death
  • Signs of left heart failure and right heart failure
Echocardiography LV cavity size
  • Significantly increased
  • Decreased
  • Decreased
EF
  • Significantly decreased
  • Normal
  • Normal or increased
Wall thickness
  • Normal or decreased
  • Significantly increased
  • Usually increased
Additional findings
  • Left ventricular (and atrial) dilation
  • Wall movement abnormalities
  • Systolic dysfunction
  • Normal diastolic function
  • Outflow tract obstruction (SAM, interventricular septum hypertrophy)
  • Reduced diastolic filling
  • Dilated atria, nondilated ventricles
  • Reduced diastolic filling
Other characteristics
  • Most common cardiomyopathy
  • Second most common cardiomyopathy
  • Most common cause of sudden heart failure in athletes and teenagers
  • Poor prognosis without heart transplant

Etiology

Pathophysiology

Distinctive clinical features Echocardiography Other characteristics
LV cavity size EF Wall thickness Additional findings
Dilated cardiomyopathy
  • Mostly idiopathic
  • Genetic predisposition (TTN gene mutation)
  • Ischemic heart disease
  • Infectious diseases
    • Coxsackie B virus
    • Chagas disease
    • HIV
  • Systemic disorders
    • Sarcoidosis
    • Hemochromatosis
    • Thiamine deficiency (wet beriberi)
  • Toxic substances
    • Cocaine
    • Alcohol
    • Medication (e.g., doxorubicin)
  • Peripartum cardiomyopathy
  • Eccentric hypertrophy of the left ventricle → ↓ ventricular contractility↓ LVEF
  • Signs of left heart failure and right heart failure
  • S3 gallop
  • Systolic murmur
  • Significantly increased
  • Significantly decreased
  • Normal or decreased
  • Left ventricular (and atrial) dilation
  • Wall movement abnormalities
  • Systolic dysfunction
  • Normal diastolic function
  • Most common cardiomyopathy

Hypertrophic cardiomyopathy

  • Inherited (autosomal dominant) mutation of:
    • Myosin binding protein C
    • β-Myosin heavy chain
  • Concentric hypertrophy of the left ventricle (including the interventricular septum) ↓ ventricular relaxation ↓ diastolic filling and systolic output → ↓ myocardial and peripheral perfusion
  • Obstructive type (HOCM): left ventricular outflow tract (LVOT) obstruction and mitral regurgitation due to systolic anterior movement (SAM) of the mitral valve Interventricular septum hypertrophy in combination with mitral valve leaflet displacement towards the interventricular septum can cause severe subaortic obstruction. [#13430]
  • Frequently asymptomatic
  • Signs of left heart failure (dyspnea, syncope, dizziness)
  • Arrhythmias
  • S4 gallop
  • Possible holosystolic murmur from mitral regurgitation
  • Sudden death
  • Decreased
  • Normal
  • Significantly increased
  • Outflow tract obstruction (SAM, interventricular septum hypertrophy)
  • Reduced diastolic filling
  • Second most common cardiomyopathy
  • Most common cause of sudden heart failure in athletes and teenagers
Restrictive cardiomyopathy
  • Mostly idiopathic
  • Systemic disorders
    • Amyloidosis
    • Sarcoidosis
    • Hemochromatosis
    • Systemic sclerosis
  • Heart disease
    • Loffler endocarditis
    • Endocardial fibroelastosis
  • Post-radiation fibrosis
  • Proliferation of connective tissue →
    • ↓ Elasticity of cardiac tissue
    • Atrial enlargement and severe diastolic dysfunction
  • Signs of left heart failure and right heart failure
  • Decreased
  • Normal or increased
  • Usually increased
  • Dilated atria, nondilated ventricles
  • Reduced diastolic filling
  • Poor prognosis without heart transplant

Etiology

Pathophysiology

Distinctive clinical features Echocardiography Other characteristics
LV cavity size EF Wall thickness Additional findings
Dilated cardiomyopathy
  • Mostly idiopathic
  • Genetic predisposition (TTN gene mutation)
  • Ischemic heart disease
  • Infectious diseases
    • Coxsackie B virus
    • Chagas disease
    • HIV
  • Systemic disorders
    • Sarcoidosis
    • Hemochromatosis
    • Thiamine deficiency (wet beriberi)
  • Toxic substances
    • Cocaine
    • Alcohol
    • Medication (e.g., doxorubicin)
  • Peripartum cardiomyopathy
  • Eccentric hypertrophy of the left ventricle → ↓ ventricular contractility↓ LVEF
  • Signs of left heart failure and right heart failure
  • S3 gallop
  • Systolic murmur
  • Significantly increased
  • Significantly decreased
  • Normal or decreased
  • Left ventricular (and atrial) dilation
  • Wall movement abnormalities
  • Systolic dysfunction
  • Normal diastolic function
  • Most common cardiomyopathy

Hypertrophic cardiomyopathy

  • Inherited (autosomal dominant) mutation of:
    • Myosin binding protein C
    • β-Myosin heavy chain
  • Concentric hypertrophy of the left ventricle (including the interventricular septum) ↓ ventricular relaxation ↓ diastolic filling and systolic output → ↓ myocardial and peripheral perfusion
  • Obstructive type (HOCM): left ventricular outflow tract (LVOT) obstruction and mitral regurgitation due to systolic anterior movement (SAM) of the mitral valve Interventricular septum hypertrophy in combination with mitral valve leaflet displacement towards the interventricular septum can cause severe subaortic obstruction. [#13430]
  • Frequently asymptomatic
  • Signs of left heart failure (dyspnea, syncope, dizziness)
  • Arrhythmias
  • S4 gallop
  • Possible holosystolic murmur from mitral regurgitation
  • Sudden death
  • Decreased
  • Normal
  • Significantly increased
  • Outflow tract obstruction (SAM, interventricular septum hypertrophy)
  • Reduced diastolic filling
  • Second most common cardiomyopathy
  • Most common cause of sudden heart failure in athletes and teenagers
Restrictive cardiomyopathy
  • Mostly idiopathic
  • Systemic disorders
    • Amyloidosis
    • Sarcoidosis
    • Hemochromatosis
    • Systemic sclerosis
  • Heart disease
    • Loffler endocarditis
    • Endocardial fibroelastosis
  • Post-radiation fibrosis
  • Proliferation of connective tissue →
    • ↓ Elasticity of cardiac tissue
    • Atrial enlargement and severe diastolic dysfunction
  • Signs of left heart failure and right heart failure
  • Decreased
  • Normal or increased
  • Usually increased
  • Dilated atria, nondilated ventricles
  • Reduced diastolic filling
  • Poor prognosis without heart transplant

Etiology

Pathophysiology

Distinctive clinical features Echocardiography Other characteristics
LV cavity size EF Wall thickness Additional findings
Dilated cardiomyopathy
  • Mostly idiopathic
  • Genetic predisposition (TTN gene mutation)
  • Ischemic heart disease
  • Infectious diseases
    • Coxsackie B virus
    • Chagas disease
    • HIV
  • Systemic disorders
    • Sarcoidosis
    • Hemochromatosis
    • Thiamine deficiency (wet beriberi)
  • Toxic substances
    • Cocaine
    • Alcohol
    • Medication (e.g., doxorubicin)
  • Peripartum cardiomyopathy
  • Eccentric hypertrophy of the left ventricle → ↓ ventricular contractility↓ LVEF
  • Signs of left heart failure and right heart failure
  • S3 gallop
  • Systolic murmur
  • Significantly increased
  • Significantly decreased
  • Normal or decreased
  • Left ventricular (and atrial) dilation
  • Wall movement abnormalities
  • Systolic dysfunction
  • Normal diastolic function
  • Most common cardiomyopathy

Hypertrophic cardiomyopathy

  • Inherited (autosomal dominant) mutation of:
    • Myosin binding protein C
    • β-Myosin heavy chain
  • Concentric hypertrophy of the left ventricle (including the interventricular septum) ↓ ventricular relaxation ↓ diastolic filling and systolic output → ↓ myocardial and peripheral perfusion
  • Obstructive type (HOCM): left ventricular outflow tract (LVOT) obstruction and mitral regurgitation due to systolic anterior movement (SAM) of the mitral valve Interventricular septum hypertrophy in combination with mitral valve leaflet displacement towards the interventricular septum can cause severe subaortic obstruction. [#13430]
  • Frequently asymptomatic
  • Signs of left heart failure (dyspnea, syncope, dizziness)
  • Arrhythmias
  • S4 gallop
  • Possible holosystolic murmur from mitral regurgitation
  • Sudden death
  • Decreased
  • Normal
  • Significantly increased
  • Outflow tract obstruction (SAM, interventricular septum hypertrophy)
  • Reduced diastolic filling
  • Second most common cardiomyopathy
  • Most common cause of sudden heart failure in athletes and teenagers
Restrictive cardiomyopathy
  • Mostly idiopathic
  • Systemic disorders
    • Amyloidosis
    • Sarcoidosis
    • Hemochromatosis
    • Systemic sclerosis
  • Heart disease
    • Loffler endocarditis
    • Endocardial fibroelastosis
  • Post-radiation fibrosis
  • Proliferation of connective tissue →
    • ↓ Elasticity of cardiac tissue
    • Atrial enlargement and severe diastolic dysfunction
  • Signs of left heart failure and right heart failure
  • Decreased
  • Normal or increased
  • Usually increased
  • Dilated atria, nondilated ventricles
  • Reduced diastolic filling
  • Poor prognosis without heart transplant