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Cardiomyopathy G021

Last amended 
6 April 2016
Current RMA Instruments:
Reasonable Hypothesis SOP
85 of 2015
Balance of Probabilities SOP
86 of 2015
Changes from Previous Instruments:

SOP Bulletin 184

ICD Coding
  • ICD-9-AM Codes: 425
  • ICD-10-AM Codes: I42; I43; O90.3; O99.4
Brief description:

This is a cardiac pathology affecting the cardiac muscle (cardiomyopathy) which is not secondarily due to coronary artery disease (ischaemic heart disease), hypertension, cardiac valvular disease, or cardiac transplant rejection.

This SOP includes genetic cardiomyopathies which do not meet the exclusion criteria above.

Confirming the diagnosis:

This is a complicated diagnosis which needs to be sought from a cardiologist with recourse to intensive investigation with echocardiography, electrocardiography and coronary artery investigations such as angiography/stress testing.

The relevant medical specialist is a cardiologist.

Additional diagnoses covered by these SOPs
  • Alcoholic cardiomyopathy
  • Cytotoxic cardiomyopathy
  • Dilated and restrictive cardiomyopathy
  • Familial hypertrophic cardiomyopathy
  • Idiopathic cardiomyopathy
  • Infiltrative cardiomyopathy
  • Primary genetic cardiomyopathy
  • Radiation cardiomyopathy
  • Secondary cardiomyopathy
  • Takotsubo (stress) cardiomyopathy
Conditions not covered by these SOPs 
  • Cardiac transplant rejection#  
  • Cardiac valve disease*     (Rheumatic heart disease; aortic stenosis)
  • Hypertension*
  • Infective myocarditis#     But may lead to cardiomyopathy as a sequela
  • Ischaemic heart disease*
  • Pericardial disease#                                   

* another SOP applies  - the SOP has the same name unless otherwise specified

# non-SOP condition

Clinical onset

The clinical onset is the earliest time prior to the confirmation of the disease, that the pathognomonic set of symptoms and signs could be documented.

Clinical worsening

The natural history of cardiomyopathy is to slowly progress and worsen.  As such, if it is considered that there is a clinical worsening, it is recommended that a report be sought from the cardiologist to ascertain whether there is a true clinical worsening out of keeping with the natural history of the underlying pathology, and the likely cause of such clinical worsening.

Further comments on diagnosis

Traditionally cardiomyopathy is generally considered as a permanent and progressive condition not due to the other common cardiac muscle pathologies which have a definite name, such as ischaemic heart disease, valvular disease or hypertension. However in this SOP, cardiomyopathy also includes some categories which are acute and temporary such as the Takotsubo cardiomyopathy, and some which are acute and non-progressive such as the carbon monoxide poisoning.