CARDIOMYOPATHY

At mid-20th century, Henry A. Christian published Non-Valvular Heart Disease. He considered this to be the most frequent form
of heart disease among individuals past middle age. At that time, acute or chronic myocarditis was thought to be the major cause;
however, he considered the role of hypertension, ventricular hypertrophy and dilatation, heart failure without enlargement, and
familial occurrence. Subsequent writers gradually shifted the emphasis from myocarditis to primary (idiopathic) myocardial
disease.

The term cardiomyopathy, referring to the noncoronary cardio- myopathies, was introduced by Wallace Brigden in 1957. During
this period, a dynamic form of subaortic stenosis was discovered and its hemodynamics investigated, and John Goodwin in
London presented a new classification based on hypertrophy, dilatation, or restriction (1961). 93 Myocardial biopsy, new imaging
modalities, and biochemical and genetic studies have reshaped the understanding of cardiomyopathy along with more precise
definition of the etiology of myocarditis. There is also a growing understanding of the contribu- tory role of genetics in the
development of the congenital/idiopathic cardiomyopathies. 94