Table 8: Nutritional disorders associated with cardiomyopathies
| Syndrome: Carnitine deficiency |
|---|
| Causes |
| Low carnitine intake |
| Symptoms and signs |
| Symptoms of heart failure; might see signs of malnutrition |
| Diagnosis |
| Blood level; endomyocardial biopsy |
| Treatment |
| Exogenous carnitine administration |
| Syndrome: Hypovitaminosis D and other causes of severe hypophosphatemia |
|---|
| Causes |
| Inadequate endogenous production of vitamin D3; poor diet or malabsorption |
| Symptoms and signs |
| Rickets in children, osteomalacia in adults |
| Diagnosis |
| Good history and physical. Ca, Mg; low 1,25(0H)2D; hypophosphatemia |
| Treatment |
| Treat underlying cause; endocrine consultation; might need supplement |
| Syndrome: Selenium deficiency |
|---|
| Causes |
| Selenium deficiency is associated with heart failure in geographic areas where dietary selenium is low |
| Symptoms and signs |
| Symptoms of heart failure |
| Diagnosis |
| History and physical |
| Treatment |
| Selenium supplement |
| Syndrome: Protein intake insufficient (kwashiorkor) |
|---|
| Causes |
| Heart failure is most likely secondary to selenium deficit in infants and young children |
| Symptoms and signs |
| Symptoms of heart failure; hypothermia, hypotension, tachycardia, edema, low pulse volume, dermatitis, and others |
| Diagnosis |
| History and physical |
| Treatment |
| Correction of fluid and electrolytes; management of associated problems |
| Syndrome: Thiamine deficiency (beriberi) |
|---|
| Causes |
| At least 3 months of diet deficient in thiamine (eg ‘polished rice’): alcohol |
| Symptoms and signs |
| Edema; high CO heart failure; peripheral neuritis; midsystolic murmur, third heart sound |
| Diagnosis |
| History and physical; decreased serum thiamine level |
| Treatment |
| Thiamine replacement |
| Syndrome: Anorexia nervosa |
|---|
| Causes |
| Malnutrition, poor diet |
| Symptoms and signs |
| Sinus bradycardia, prolonged QT, arrhythmias, cardiomegaly |
| Diagnosis |
| History, physical, body mass index, electrolytes, blood urea nitrogen, creatinine, echocardiography, electrocardiogram |
| Treatment |
| Supportive; good nutrition; psychological support; monitor serum electrolytes |