A SYSTEMIC REVIEW HYPOKINETIC NONDILATED CARDIOMYOPATHY, AN UNDER DIAGNOSED, UNDER ESTIMATED SUBCATEGORY OF DILATED CARDIOMYOPATHY: NEEDS REDRESSAL

Abstract

 Hypokinetic non-dilated cardiomyopathy (HNDC) is a subtype of DCM, characterised by LV
dysfunction, despite absence of LV dilatation. It is most often underdiagnosed and undertreated by
physicians due to presence of subclinical symptoms and signs along with subtle radiological and
electrocardiographic manifestations. However, a proportion of patients with specific characteristics
may develop end stage disease and life-threatening arrhythmia with grievous outcomes. Therefore a
systemic qualitative analytic study conducted collecting and compiling all the literatures and guidelines
related to HNDC and its related groups to find out high risk groups of patients in terms of
arrhythmogenicity or progression of disease. An attempt was also initiated to derive a solution about
early accurate diagnosis of patients with HNDC and its related groups. During analysis we obtained
useful information’s as described below. Family history with genetic association is an important
prognostic marker with poor outcomes. Elicitation of family history and pre-degree analysis also help
early diagnosis and prevention of progression of disease in relatives. Red flag approach to detect
specific clinical, electrocardiographic, radiological signs and laboratory findings can help to detect
familial disease with poor outcomes. Screening echocardiography single most important tool to
confirm the diagnosis at an earlier stage and prognostication of patients. Speckle tracking is a higher
modality of echocardiographic tool,that has greater sensitivity to detect subtle abnormalities of systolic
function at an earlier stage. Biomarkers like NT-probnp can have a role in suspecting heart failure in
patients without significant cardiomegaly. High risk group of patients can be detected at an earlier
stage by stratifying patients as per their family history, genotype, electrocardiographic,
echocardiographic, radiologic findings and biomarkers value, so that appropriate measures can be
taken at an earlier stage .