UMEM Educational Pearls

The Heart Is Just a Muscle

- Heart failure and peripheral myopathies share similar symptoms such as exertional fatigue, weakness, and dyspnea.

- The role of endomyocardial biopsy (EMB) to aid in the diagnosis of new-onset heart failure is controversial and major society guidelines recommend against this procedure in the routine evaluation of patients with heat failure.

- Nevertheless when symptoms of heart failure persist despite conventional imaging modalities and treatment one must consider uncommon conditions, such as mitochondrial disorders. 

 - Mitochondrial disorders are characterized as clinical syndromes and patients can present with any one of the following: ophthalmoplegia, proximal muscle weakness, isolated myopathy with exercise intolerance and myalgia, severe myopathy of infancy or childhood, or multisystem involvement with myopathy.

- Myocardial tissue is highly dependent on mitochondria for energy production and is therefore susceptible to defects in mitochondrial function. Cardiac manifestations of these syndromes include both arrhythmias and cardiomyopathy. 


McGarrah R. et al. The Heart is Just a Muscle. Circulation. March 2015.