Clinical demonstrations PROFESSOR

WE present the case histories and documentation on a number of patients who illustrate certain aspects of the cardiomyopathies, starting with three patients who demonstrate some of the features and problems of congestive cardiomyopathy. Case 1 is a so-called 'index' case with the clear characteristics of congestive cardiomyopathy. Case 2 confused the issue by presenting with angina and therefore simulated ischaemic heart disease, an important and difficult problem. Case 3 did the reverse; he presented with heart failure without a definite episode of cardiac infarction but was found to have severe coronary artery disease and thus his myocardial failure was due to this and not to cardiomyopathy. Then three patients (Cases 4, 5 and 6) with hypertrophic cardiomyopathy will be presented who illustrate some of the familial aspects, some of the diagnostic difficulties and the importance of histological evidence. Finally, we shall discuss some patients who demonstrate certain forms of secondary cardiomyopathies. These will be three patients with skeletal muscular dystrophy (Cases 7, 8 and 9) and a patient with acromegaly (Case 10) all of whom presented with, or came to our notice with severe myocardial disease and heart failure.