Imaging of Nonischemic Cardiomyopathy

Spectrum of Thoracic Imaging Findings in the Setting of Substance Abuse

“…Similar to its clinical presentation, ACM does not have specific imaging findings differentiating it from other NI-DCMs overall 31,32 . Radiographic findings can include cardiomegaly, pulmonary edema, and pleural effusions 30 .…”

“…29,30 The diagnosis of ACM is determined by the absence of other cardiomyopathy causes with a significant history of chronic alcohol consumption (>80 g/d or 8 standard alcoholic drinks for at least 5 years). 30,31 High levels of ethanol result in the generation of free radicals, oxidative stress, and mitochondrial damage. 29,30 Cardiac myocytes are especially susceptible to oxidative stress because energy levels must remain high for persistent sarcomere contractions.…”

“…29,30 Similar to its clinical presentation, ACM does not have specific imaging findings differentiating it from other NI-DCMs overall. 31,32 Radiographic findings can include cardiomegaly, pulmonary edema, and pleural effusions. 30 Echocardiography is essential for diagnosis to assess for ventricular dilation and ventricular function and exclude other causes of cardiomyopathy, but cardiac magnetic resonance imaging (CMR) may also be utilized if echocardiography images are suboptimal.…”

“…8). 31,33 Although ACM is generally thought to not possess any unique features compared with other cardiomyopathies, one study comparing ACM patients to NI-DCM patients found septal late gadolinium enhancement localization in ACM patients compared with lateral localization in NI-DCM patients, which may be an area for further research. 33…”

“…Patients with ACM present similarly to those with heart failure, with symptoms including exertional dyspnea, orthopnea, and peripheral edema 29,30 . The diagnosis of ACM is determined by the absence of other cardiomyopathy causes with a significant history of chronic alcohol consumption (>80 g/d or 8 standard alcoholic drinks for at least 5 years) 30,31 . High levels of ethanol result in the generation of free radicals, oxidative stress, and mitochondrial damage 29,30 .…”