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Dilated cardiomyopathy is a condition in which the heart becomes weakened and enlarged, and it cannot pump blood efficiently. The decreased heart function can affect the lungs, liver, and other body systems.
There are several different types of cardiomyopathy. Dilated cardiomyopathy is the most common form.
See also:
Alternative NamesCardiomyopathy - dilated
Causes, incidence, and risk factorsThere are many causes of dilated cardiomyopathy. Some of these are:
- Alcohol (alcoholic cardiomyopathy) or cocaine abuse
- Atrial fibrillation, supraventricular tachycardia, or other heart rhythm problems in which the heart beats very fast for a long period of time (called Tachycardia-mediated cardiomyopathy)
- Autoimmune illnesses that involve the heart, such as systemic lupus erythematosus and rheumatoid arthritis
- Catecholamine excess from a tumor that releases catecholamines (pheochromocytoma)
- Coronary artery disease (See: Ischemic cardiomyopathy)
- Deficiencies of certain vitamins and minerals (thiamine, calcium, magnesium)
- End-stage kidney disease
- Family history of cardiomyopathy (some cardiomyopathies run in families and have a genetic component)
- Infections that involve the heart muscle, such as viruses, HIV infection, Chagas disease, and Lyme disease
- Inherited disorders such as muscular dystrophy
- Medications that can be toxic to the heart (such as some chemotherapy drugs used to treat cancer)
- Poorly controlled high blood pressure
- Pregnancy (See: Peripartum cardiomyopathy)
- Stress-induced cardiomyopathy
- Trace elements, such as lead, arsenic, or Mercury
This condition can affect anyone at any age. However, it is most common in adult men.
The most common causes of dilated cardiomyopathy in children are:
- Heart (coronary) disease
- Myocarditis
- Some infections
- Unknown cause (idiopathic dilated cardiomyopathy)
Symptoms of heart failure are most common. Usually, they develop slowly over time. However, sometimes symptoms start very suddenly and are severe. Common symptoms are:
- Shortness of breath with activity or after lying down (or being asleep) for a while, or in infants while feeding
- Swelling of feet and ankles (in adults)
- Irregular or rapid pulse
- Fatigue, weakness, faintness
- Swelling of the abdomen (in adults)
- Loss of appetite
- Cough
Other symptoms may include:
- Chest pain
- Decreased alertness or concentration
- Failure to thrive (in children)
- Low urine production
- Need to urinate at night (in adults)
- Shock
Cardiomyopathy is usually discovered when the doctor is examining and testing you for the cause of heart failure.
- Tapping over the heart with the fingers and feeling the area may indicate that the heart is enlarged.
- Listening to the chest with a stethoscope reveals lung crackles, heart murmur, or other abnormal sounds.
- The liver may be enlarged.
- Neck veins may be bulging.
A number of laboratory tests may be done to determine the cause:
- Antinuclear antibody (ANA), erythrocyte sedimentation rate (ESR), and other tests to diagnose autoimmune illnesses
- Antibody test to identify infections such as Lyme disease and HIV
- Serum TSH and T4 test to identify thyroid problems
Children will have:
- Poor growth
- Pale skin
- Difficulty feeding
- Weak pulses in the legs and arms
Heart enlargement, congestion of the lungs, decreased movement/functioning of the heart, or heart failure may show on these tests:
- Echocardiogram(ultrasound of the heart)
- Cardiac stress tests
- Cardiac catheterization and coronary angiography
- Chest CT scanor MRI of the heart
- Chest x-ray
- Nuclear heart scan (MUGA, RNV)
Other tests may include:
Lab tests vary depending on the suspected cause.
TreatmentWhen the cause of the dilated cardiomyopathy can be found, that condition is treated. For example, high blood pressure or coronary artery disease should be treated. If alcohol or cocaine use is the cause, your doctor will ask you to stop using them. Sometimes, no specific cause can be found, but the treatments listed below will still be used.
Attempts are also made to find a "trigger" that may have caused a sudden worsening in a patient's symptoms. Examples include not taking medication correctly, increasing salt or fluid intake, or drinking excess alcohol.
Treatment for cardiomyopathies focuses on treating heart failure. Drugs and treatments that may be used include:
- ACE inhibitors, such as captopril, enalapril, lisinopril, and ramipril
- Angiotensin receptor blockers (ARBs) such as losartan and candesartan
- Beta-blockers, such as carvedilol and metoprolol
- Diuretics, including thiazide, loop diuretics, and potassium-sparing diuretics
- Digitalis glycosides
- Drugs that dilate blood vessels (vasodilators)
See also: Heart failure
Some people may benefit from the following heart devices:
- Single or dual-chamber pacemaker
- Biventricular pacemaker
- Implantable cardioverter-defibrillator
- Left ventricular assist device (LVAD)
A low-salt diet may be prescribed for adults, and fluid may be restricted in some cases. You can usually continue your regular activities, if you are able.
You may be asked to monitor your body weight daily. Weight gain of 3 pounds or more over 1 or 2 days may indicate fluid buildup (in adults).
Avoid smoking and drinking alcohol, which may make the symptoms worse.
If the heart function remains poor, a heart transplant may be considered.
Expectations (prognosis)The outcome varies. Some people remain in a stable condition for long periods of time, some continue to gradually get sicker, and others quickly get worse. Cardiomyopathy can only be corrected if the disease that caused it can be cured.
About one-third of children recover completely, one-third recover but continue to have some heart problems, and one-third die.
Complications- Arrhythmias
- Congestive heart failure
- Pulmonary edema
- Side effects of medications, including:
- Headache
- Gastrointestinal upset
- Light-headedness and fainting
- Low blood pressure
- Lupus reaction (a group of symptoms including a skin rash and Arthritis)
Call your health care provider if you have symptoms of cardiomyopathy.
If chest pain, palpitations, or faintness develop seek emergency medical treatment immediately.
Prevention- Eat a well-balanced and nutritious diet
- Exercise to improve heart fitness
- Stop smoking
- Minimize alcohol consumption
Hare JM. The dilated, restrictive, and infiltrative cardiomyopathies. Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 64.
Wexler RK, Elton T, Pleister A, Feldman D. Cardiomyopathy: An overview. Am Fam Physician. 2009;79:778-784.
Bernstein D. Diseases of the myocardium. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 439.
What else can I help you with?
What are some symptoms of dilated cardiomyopathy?
Dilated cardiomyopathy means that the heart is not pumping blood as it should be, resulting in symptoms such as fatigue and weakness, shortness of breath and swelling of the abdomen.
What is Dialated cardial myopathy?
Cardiomyopathy is a disorder of the heart muscle. There are four main types of cardiomyopathy: * Dilated cardiomyopathy - where the heart dilates (enlarges). * Hypertrophic cardiomyopathy - where the heart muscle becomes thickened ('hypertrophied'). * Restrictive cardiomyopathy - where the heart muscle cannot relax properly between heartbeats. This is rare. * Arrhythmogenic right ventricular - a rare type which mainly affects the right side of the heart. Dilated cardiomyopathy In this condition the heart muscle is weakened. The ventricles then dilate (enlarge) as their muscular walls are weaker and more 'floppy' than normal. Therefore, the heart does not pump blood as strongly as normal. (Note: other common heart conditions can cause a dilated heart. For example, coronary heart disease, high blood pressure and heart valve disease. These conditions can put a 'strain' on the heart which may cause the heart to dilate. With dilated cardiomyopathy, the heart dilates because of a problem or disease of the heart muscle itself.) About 2 in 10, 000 people in the UK develop dilated cardiomyopathy each year. People at any age and either sex may be affected.
How long would a person live for whos has dilated cardiomyopathy and drinks alcohol?
Not as long as long as you would if you DIDN'T drink alcohol.
Do people with alcoholism die of congestive heart failure?
Chronic alcoholism can lead to dilated cardiomyopathy which consequently can result in congestive heart failure.
How can you treat dilated cardiomyopathy?
Dilated cardiomyopathy is usually treated with combination of Beta Bloockers (Coreg, Cardevilol) and blood pressure lowering medication (Enalapril). Also in order to stabilize heart rhythm Digoxin could be prescribed. In some severe cases, when patient's body is reatining water, water pill must be admistired (Furosemide, Lasics). In this case patient also needs to take Potassium pill to compensate possible potassium deficinecy. Blood work need to be performed regurally checking Potassium level in blood. American cardiologists look scepticly at nutritional supplement CQ 10, however their Europian collegs highly valued CQ 10 as essential medicine for patients with dilated cardiomyopathy and congestive heart failure. http://www.medgrip.com/cardiomyopathy/cardiomyopathy_medicine.html
How long can you survive cardiomyopathy without a heart transplant?
It depends on the severity of the case. A friend of mine was lucky to be in the hospital before the worst of it kicked in. He nearly had a heart transplant, but in the end, didn't get on. He's been living for over 10 years with his heart regulated by a constant series of medications and cardiologist visits. There are a variety of types of cardiomyopathy, including hypertrophic, dilated and arrhythmogenic right ventricular cardiomyopathy. Heart transplants are more commonly used in dilated cardiomyopathy but with appropriate care and today's drug treatments (including betablockers and ACE inhibitors) and heart devices (including biventricular pacemakers and implantable cardioverter defibrillators - ICDs) most affected people will never need a heart transplant. More details can be found on the Cardiomyopathy Association website
What is ventricular dilation?
A dilated ventricle is known as dilated cardiomyopathy. It is a form of heart disease that results in an enlarged left ventricle. There are treatments for the disease, but the illness can be fatal and not show any symptoms before the person suddenly dies.
What work can you do with dilated cardiomyopathy?
With dilated cardiomyopathy, patients can engage in various forms of work depending on their individual health status and symptoms. Light to moderate physical activities may be manageable, while more strenuous jobs might require adjustments or limitations. It's crucial for individuals to consult with their healthcare provider to determine appropriate activities and ensure they don't exacerbate their condition. Additionally, work that allows for flexible hours or remote options may be more suitable for those managing the condition.
Can a low ejection fraction be increased?
Yes. I have congestive dilated cardiomyopathy. In 2006 my EF was 125. My cardiologist prescribed beta blockers and meds to lower my BP. Now my EF is 135-140. I rest a lot and watch my diet carefully.
What is the Batista Operation?
It is a radical heart surgery to reduce the size of enlarged heart (dilated cardiomyopathy) without transplant. It was successfully tried for first time in the country at the Institute of cardiovascular disease, Chennai. This methodology was developed by Randos J.V.Batista of Brazil.
How can you differentiate acquired and congenital dilated cardiomyopathy?
Acquired dilated cardiomyopathy (DCM) develops due to external factors such as infections, toxins, or ischemia, often occurring later in life, while congenital DCM is present at birth and results from genetic mutations or developmental issues. Clinical history, family history, and age of onset can help differentiate the two. Diagnostic imaging and genetic testing may also provide insights, with congenital cases often revealing familial patterns and specific genetic markers. In contrast, acquired cases may show signs related to underlying conditions or environmental influences.
What is a floppy heart?
It is a form of cardiomyopathy (heart muscle disease) in which the heart is weakened, dilated and cannot adequately pump the blood through the body (CBC health news). It is more common in men than women. Two possible causes are chemotherapy and viral infections.
