Cardiac steatosis (fatty heart) is due to accumulation of lipid within the heart. The accumulation of free fatty acids, triglycerides and other lipids may be myocardiotoxic, resulting in heart failure (lipotoxic cardiomyopathy).


Risk factors:

(1) diabetes mellitus

(2) obesity, especially morbid obesity

(3) dyslipidemia


A patient with cardiac steatosis would be expected to be at risk for nonalcoholic steatosis (NASH) and the metabolic syndrome.


Clinical features:

(1) evidence of increased fat within the heart by magnetic resonance spectroscopy or other imaging method

(2) diastolic and/or dystolic dysfunction, with congestive heart failure and a dilated heart

(3) exclusion of other conditions associated with cardiomyopathy


If the disease is identified early enough then aggressive weight loss may result in improved ventricular function.


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