The diagnosis of atrial cardiomyopathy can be made if certain findings are present.
Patient selection: atrial failure
Criteria for the diagnosis of atrial cardiomyopathy:
(1) mechanical and/or electrophysiological dysfunction of the atrium
(2) one or more structural changes that are inappropriate:
(2a) atrial fibrosis (resulting in increased stiffness and reduced contractility)
(2b) atrial hypertrophy
(2c) atrial dilatation
(3) functional impairment
If no underlying cause is identified, then designated idiopathic.
In most cases the cardiomyopathy is not limited to the atria.
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Histologic Features
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EHRAS Class
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myocyte changes with hypertrophy or myocytolysis; no fibrosis; no interstitial alerations
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I
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primarily fibrosis
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II
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cardiomyocyte changes AND fibrosis
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III
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change in interstitial matrix without prominent collagen fiber accumulation
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IV
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accumulation of amyloid
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IVa
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fatty infiltration
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IVf
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inflammatory cells
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IVi
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other insterstitial alterations
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IVo
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