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6 The patient pathway The diagnosis of cardiomyopathy rests on the identification of structural and/or functional myocardial abnormalities, including myocardial fibrosis, that are not explained solely by abnormal loading conditions or CAD. However, disease phenotypes can also include arrhythmic and electrocardiographic manifestations, morphological abnormalities of the cardiac valves, and abnormal coronary microcirculatory function. As a key theme throughout this guideline, the Task Force highlights the importance of using a systematic approach to the identification and assessment of patients with a suspected cardiomyopathy. Central to this is the need for clinicians to consider a diagnosis of cardiomyopathy as the cause of several common adult and paediatric clinical presentations. The identification of a cardiomyopathy phenotype is only the beginning of the diagnostic process and should prompt a systematic search for the underlying aetiology, which may be genetic or acquired. Cardiologist with cardiomyopathy expertise Paediatric cardiologist with cardiomyopathy expertise Specialist nurse Cardiac genetic counsellor Heart failure team Arrhythmia team Cardiac imaging team Interventional cardiologist team Cardiologist with expertise in sports cardiology Geneticist Family/carer(s) Psychologist Patient associations Patient support Cardiomyopathy specialists Other related specialtiesa Other related cardiology experts Pathologist Other: cardiac surgeon, primary care physician, paediatrician, internist, nephrologist, neurologist, dermatologist, endocrinologist, ophthalmologist, pharmacist, rheumatologist etc. Figure 5 Multidisciplinary care of cardiomyopathies. aThe list presented is not exhaustive and represents examples of specialties that often interact in the care of cardiomyopathy patients.Image %: Recommendation Table 1 — Recommendations for the provision of service of multidisciplinary cardiomyopathy teams Recommendations Classa Levelb It is recommended that all patients with cardiomyopathy and their relatives have access to multidisciplinary teams with expertise in the diagnosis and management of cardiomyopathies. I C Timely and adequate preparation for transition of care from paediatric to adult services, including joint consultations, is recommended in all adolescents with cardiomyopathy.58,59 I C © ESC 2023 aClass of recommendation. bLevel of evidence. ESC Guidelines 3519 Downloaded from academic.oup.com/eurheartj/article/44/37/3503/7246608 by guest on 07 October 2026