Point of View Assignment of Patients Into the Classification of Cardiomyopathies

"... . any classification is necessarily incomplete and acts as a bridge between complete ignorance and total understanding...." (Goodwin JF: The frontiers of cardiomyopathy, Br Heart J 1982;48:1-18) nhe conditions we now call cardiomyopathies were regarded as a diversity of "uncommon noncoronary myocardial diseases" in the 1950s.' Goodwin and colleagues2 defined cardiomyopathies as "4primary heart muscle diseases" and attempted their first classification in the 1960s. Subsequently, the definition and classification of cardiomyopathies were modified as their major structural and functional abnormalities were appreciated.34 Currently, cardiomyopathies are defined as "heart muscle diseases of unknown etiology."5 This definition distinguishes cardiomyopathies from other recognizable processes affecting the myocardium such as arterial hypertension and coronary, valvular, or congenital heart disease. The cardiomyopathies also are differentiated from "specific heart muscle disease" in which the myocardial disease is part of a known systemic disorder.35'6 This definition automatically excludes conditions in which the cause of the myocardial pathology or a specific pathological process can be clearly defined. However, this segregation is not accepted by all.7'8 Myocardial toxins such as alcohol and doxorubicin lead to ventricular dysfunction. Clinicians