XXXX : current concepts.

@entity1 @entity662 @entity101 @entity6 @entity66 @entity500 @entity384 @entity229 @entity2554 @entity281 @entity951 @entity2473 @entity460 @entity583 @entity340 @entity943 @entity1068 @entity942
@entity384 is a moderately common syndrome resulting from many causes, many of which are yet to be defined. The syndrome is relatively easy to diagnose in its late congestive stage if @entity340 , @entity101 , and gross @entity583 are absent. However, it should be suspected in @entity1 with undiagnosed @entity662 , in @entity1 whose severe @entity943 has no obvious cause, and in any @entity1 with demonstrable @entity2554 or systolic malfunction. It may follow @entity281 , especially viral ones and is found in many @entity942 , especially @entity6 . Repeated episodes of @entity951 due to @entity66 may result in myocardial "stunning" with ultimate dilation and failure. Microvascular @entity2473 or occlusion may be etiologically important. @entity384 may be a manifestation of toxins, with @entity1068 being the most important. Immune mechanisms may play a major role, either independently or in connection with other factors. Early diagnosis may be made with the help of echocardiography, radionuclide angiography, and even coronary arteriography. Gallium scan may be helpful, and if positive myocardial biopsy is indicated. Therapy includes classic measures for congestive failure if it is present: cardiac glycosides, diuretics, antiarrhythmics, and anticoagulants. There is evidence that vasodilators, @entity460 channel blockers, and beta-adrenergic blockers may be helpful for both general and specific reasons, but these should be used with care. @entity229 and @entity500 may help if there is an inflammatory component. Cardiac replacement remains an ultimate measure.
