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Dilated Cardiomyopathy: A Condition Where the Heart Muscle Becomes Weakened and Enlarged

Dilated cardiomyopathy is a type of heart muscle disease that affects the heart's ability to pump blood efficiently. The condition causes the heart chambers (ventricles) to thin and stretch, growing larger [4]. This typically starts in the heart's main pumping chamber, called the left ventricle [13].

As a result of this weakening, the heart has trouble pumping blood to the rest of the body [1][3]. The condition can affect people of all ages, but it is more common in adults younger than 50 [2]. In Black people, dilated cardiomyopathy is more prevalent compared to white people [2].

The symptoms of dilated cardiomyopathy can vary from person to person. Some may experience shortness of breath or fatigue during physical activity, while others might have severe heart failure and kidney problems [3][5]. The condition can progress over time, leading to long-term heart failure if left untreated.

Key Facts:

• Dilated cardiomyopathy affects the heart's ability to pump blood efficiently.
• The condition causes the heart chambers (ventricles) to thin and stretch, growing larger.
• It typically starts in the heart's main pumping chamber, called the left ventricle.
• The condition can affect people of all ages, but it is more common in adults younger than 50.
• In Black people, dilated cardiomyopathy is more prevalent compared to white people.

References:

[1] Dilated cardiomyopathy refers to a condition in which the heart muscle becomes weakened and enlarged, causing it to pump less blood to the body. [4] [2] Dilated cardiomyopathy (DCM) is the most common type, occurring mostly in adults younger than 50. It affects the heart's ventricles and atria, the lower and upper chambers of the heart. Dilated cardiomyopathy is more common in Black people than in white people. [2] [3] Dilated cardiomyopathy can get worse for many people and lead to long-term heart failure. This means your heart can’t keep up with the demands on it. Kidney failure and severe heart failure are signs of a poor prognosis (outcome). People who have symptoms at rest or can’t do physical activity tend to have the worst prognosis. [3] [4] Dilated cardiomyopathy refers to a condition in which the heart muscle becomes weakened and enlarged, causing it to pump less blood to the body. [4] [13] Types of cardiomyopathy include: Dilated cardiomyopathy. In this type of cardiomyopathy, the heart's chambers thin and stretch, growing larger. The condition tends to start in the heart's main pumping chamber, called the left ventricle. As a result, the heart has trouble pumping blood to the rest of the body. This type can affect people of all ages. [13]

Common Signs and Symptoms of Dilated Cardiomyopathy

Dilated cardiomyopathy is a condition where the heart's ability to pump blood is weakened, leading to various symptoms. Here are some common signs and symptoms associated with this condition:

• Shortness of breath: This is one of the most common symptoms of dilated cardiomyopathy, especially when exerting oneself or lying down [3].
• Fatigue: Patients often experience unusual tiredness due to the heart's inability to pump enough blood [2].
• Swelling (edema): Fluid buildup in the legs, ankles, feet, and abdomen can occur due to the heart's failure to efficiently pump blood [1].
• Chest pain or pressure: This symptom may be more pronounced with exercise and is a common sign of dilated cardiomyopathy [4].

Other symptoms that may be present include:

• Dizziness or lightheadedness
• Fainting (in severe cases)
• Irregular or rapid pulse
• Loss of appetite

It's essential to note that these symptoms can vary in severity and may not always be present. If you're experiencing any of these symptoms, it's crucial to consult a healthcare professional for proper diagnosis and treatment.

References: [1] - Symptoms · Fatigue · Shortness of breath (dyspnea) during activity or while lying down · Reduced ability to exercise · Swelling (edema) in the legs, ankles, feet or ... [2] - What are the symptoms? · Chest pain · Cough and congestion · Dizziness or lightheadedness · Fainting · Fatigue (unusual tiredness) · Palpitations or fluttering in ... [3] - What are the symptoms of dilated cardiomyopathy? · Shortness of breath with exertion (may progress to shortness of breath when at rest) · Shortness of breath when ... [4] - Feb 27, 2024 — Symptoms · Chest pain or pressure (more likely with exercise) · Cough · Fatigue, weakness, faintness · Irregular or rapid pulse · Loss of appetite ...

Diagnostic Tests for Dilated Cardiomyopathy

Dilated cardiomyopathy (DCM) can be diagnosed through a combination of medical history, physical examination, and various diagnostic tests.

• Echocardiography: This is the first-line imaging test in assessing patients with DCM. It provides crucial information not only for diagnosis but also for risk stratification [1]. Echocardiography helps evaluate the size and function of the heart chambers, as well as blood flow patterns within the heart [8].
• Electrocardiogram (ECG): An ECG can help identify abnormal heart rhythms or other signs that may indicate DCM [7].
• Chest X-ray: A chest X-ray can show an enlarged heart and fluid accumulation in the lungs, which are common findings in patients with DCM [4].
• Blood tests: Blood tests may be done to check iron levels and assess kidney, thyroid, and liver function, as these organs can be affected by DCM [4].
• Cardiac MRI: This imaging test can provide detailed information about the heart's structure and function, which is useful for diagnosing and managing DCM [6].
• Endomyocardial biopsy (selected cases): In some cases, a biopsy may be performed to rule out other conditions that may mimic DCM [2].

Additional Tests

In patients with suspected DCM, the following tests may also be performed:

• Complete blood cell (CBC) count
• Testing for cause as indicated

It's essential to note that the diagnostic workup in patients with suspected DCM can vary depending on individual circumstances and the presence of other medical conditions.

References: [1] T Mathew · 2017 · Cited by 103 [2] [4] Feb 21, 2024 [6] by A Ferreira · 2023 · Cited by 13 [7] How is dilated cardiomyopathy diagnosed? · Echocardiogram, to examine blood flow in the heart and heart motion using ultrasound · Electrocardiogram (ECG) to ... [8] How is dilated cardiomyopathy diagnosed? · Echocardiogram to look at blood flow in the heart, the size of the heart chambers, and heart motion using ultrasound ...

Medications Used to Treat Dilated Cardiomyopathy

Dilated cardiomyopathy can be managed with various medications, which help alleviate symptoms and improve quality of life. The primary goal of drug treatment is to reduce the heart's workload, slow down its deterioration, and prevent complications.

• Diuretics (water pills): These are used to reduce swelling in the body by removing excess fluid. They can help alleviate shortness of breath and fatigue.
• Beta-blockers: These medications reduce the heart's workload by slowing down its rate and reducing the force of each beat. This helps decrease the demand on the heart, allowing it to function more efficiently.

According to [3], loop diuretics are necessary adjuncts in medical therapy for heart failure when symptoms are due to sodium and water retention. They are considered a mainstay in managing fluid overload.

A combination of different medications and conventional therapy may increase the clinical effectiveness of treating dilated cardiomyopathy, as suggested by [8]. Beta-blockers, in particular, have been shown to improve survival rates and reduce hospitalizations in patients with heart failure.

While these medications can help manage symptoms and slow disease progression, they do not cure dilated cardiomyopathy. A comprehensive treatment plan may involve a combination of medications, lifestyle modifications, and other interventions tailored to individual needs.

References: [3] - Loop diuretics are necessary adjuncts in the medical therapy for HF when symptoms are due to sodium and water retention. [8] - A combination of different medications and conventional therapy may increase the clinical effectiveness of treating dilated cardiomyopathy.

Differential Diagnosis of Dilated Cardiomyopathy

Dilated cardiomyopathy (DCM) is a progressive disease of the heart muscle that can be challenging to diagnose, as it shares similar symptoms with other cardiac conditions. Therefore, a comprehensive differential diagnosis is essential to exclude secondary causes of left ventricular dysfunction.

Common Causes of Left Ventricular Dysfunction:

• Coronary Artery Disease: Acute coronary syndrome, myocardial infarction, and stable angina can all lead to left ventricular dysfunction.
• Hypertension: Uncontrolled high blood pressure can cause left ventricular hypertrophy and eventual dilatation.
• Diabetes Mellitus: Diabetic cardiomyopathy is a recognized entity that can mimic DCM.
• Thyroid Disease: Both hyperthyroidism and hypothyroidism can affect the heart, leading to left ventricular dysfunction.
• Viral Infections: Viral myocarditis can cause inflammation of the heart muscle, leading to dilatation and dysfunction.
• Autoimmune Diseases: Conditions like polymyositis and lupus can affect the heart, mimicking DCM.
• Alcohol Abuse: Chronic heavy drinking can lead to alcoholic cardiomyopathy, a form of DCM.
• Cocaine Use: Cocaine abuse is associated with an increased risk of developing DCM.

Other Conditions to Consider:

• Cardiac Tamponade: A life-threatening condition where fluid accumulates in the pericardial sac, compressing the heart and impairing its function.
• Acute Pericarditis: Inflammation of the pericardium can lead to cardiac dysfunction and mimic DCM.
• Hypertrophic Cardiomyopathy: A genetic disorder that causes thickening of the heart muscle, leading to impaired contractility.

Importance of Comprehensive Evaluation:

A thorough evaluation is crucial to accurately diagnose DCM and exclude secondary causes of left ventricular dysfunction. This includes a detailed medical history, physical examination, laboratory tests, imaging studies (such as echocardiography and cardiac MRI), and sometimes genetic testing.

References:

• [1] Dilated Cardiomyopathy (DCM) Differential Diagnoses. Updated: Sep 24, 2024 Author: Jian Hu, MD, PhD; Chief Editor: Gyanendra K Sharma, MD, FACC
• [2] by A Ferreira · 2023 · Cited by 13 — 3. Differential Diagnosis.
• [5] Dec 29, 2019 — Dilated cardiomyopathy should be differentiated from other causes of cardiac dysfunction.
• [15] Dilated cardiomyopathy (DCM) is a heart muscle disease characterized by left ventricular or biventricular dilatation or systolic dysfunction without either pressure or volume overload or coronary artery disease sufficient to explain the dysfunction.