Current RMA Instruments
Reasonable Hypothesis SOP | 57 of 2024 as amended by 53 of 2025 |
|---|---|
Balance of Probabilities SOP | 58 of 2024 as amended by 54 of 2025 |
Changes from previous Intruments
ICD Coding
- ICD-10-AM Codes: I42; I43; O90.3
Brief Description
Cardiomyopathy is a group of acquired diseases of the heart muscle leading to the inability to pump blood effectively and disturbance to the electrical signals controlling heart rate and rhythm.
Confirming the diagnosis
The assessment of this condition is complicated and requires the opinion of a cardiologist.
Investigations may involve echocardiography, electrocardiography and coronary artery angiography/stress testing to exclude other possible diagnoses.
Additional diagnoses covered by SOP
- Alcoholic cardiomyopathy
- Cytotoxic cardiomyopathy
- Dilated cardiomyopathy
- Restrictive cardiomyopathy
- Familial hypertrophic cardiomyopathy
- Idiopathic cardiomyopathy
- Infiltrative cardiomyopathy
- Primary genetic cardiomyopathy
- Radiation cardiomyopathy
- Secondary cardiomyopathy
- Takotsubo (stress) cardiomyopathy
- Myocarditis with persistent mechanical or electrical dysfunction
- Hypertrophic cardiomyopathy
- Arrhythmogenic cardiomyopathy
- Hypertensive cardiomyopathy
- Peripartum/Postpartum cardiomyopathy
- Septic cardiomyopathy
- Left ventricular noncompaction
* This SOP includes genetic cardiomyopathies which do not meet the exclusion criteria
Conditions not covered by SOP
- Cardiac transplant rejection #
- Myocardial abnormality caused by valvular disease* - Cardiac valve disease SOPs (Rheumatic heart disease; Aortic stenosis; Mitral Valve Prolapse)
- Hypertension* - Hypertension SOP
- Infective myocarditis* - Myocarditis SOP (May lead to cardiomyopathy as a sequela)
- Myocardial abnormality caused by ischaemic heart disease* - Ischaemic heart disease SOP
- Pericardial disease including pericarditis* - Pericarditis SOP
- Exercise-induced cardiac remodelling (athlete’s heart) #
*another SOP applies
#non-SOP condition
Clinical onset
Once the diagnosis has been established, the clinical date of onset can be taken from the earliest time in which the individual presented with symptoms and signs consistent with cardiomyopathy and that cannot be attributed to other conditions. Common symptoms of cardiomyopathy may include chest pain, shortness of breath, swelling in the lower limb, dizziness, fatigue etc.
Clinical worsening
The prognosis for cardiomyopathy varies depending on the type, severity and underlying cause(s). With treatment, many people can live and function reasonably well. However, the natural history of cardiomyopathy is to slowly progress and worsen. Any considerations related to possible clinical worsening would need the assessment of a cardiologist to ascertain whether there is a true clinical worsening out of keeping with the natural history of the underlying pathology.