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Alternative namesCardiomyopathy - dilated; Congestive cardiomyopathy
DefinitionDilated cardiomyopathy is a disorder in which the heart muscle is weakened and cannot pump blood efficiently. The wall (muscle) of the ventricles may be of normal, increased or reduced thickness, but the ventricular diameter is always enlarged. This causes decreased heart function that affects the lungs, liver, and other body systems.
Causes, incidence, and risk factors
Dilated cardiomyopathy represents the end result of more than 50 different diseases. Causes of dilated cardiomyopathy include genetic disorders such as Friedreich's ataxia or myotonic dystrophy, myocarditis (a viral infection of the heart muscle), alcoholism , coronary artery disease , valvular heart disease, and others. In many patients, however, a cause cannot be identified, and their cardiomyopathy is considered "idiopathic." Idiopathic cardiomyopathies are likely to be genetically determined.
Dilated cardiomyopathy is the most common of the cardiomyopathies, comprising more than 90% of all cases that are referred to specialized centers.
Symptoms often develop gradually and usually include symptoms of right heart failure , left heart failure, or both.
Chest pain is surprisingly common and affects not only patients with coronary artery disease but also up to 35% of patients with normal coronary
Dilated cardiomyopathy usually causes heart failure .
A heart biopsy may help determine the cause of dilated cardiomyopathy.
Hospitalization may be required when symptoms are severe. Treatment is essentially the same as that for heart failure . A low-salt diet may be recommended. Advice to stop smoking and stop drinking alcohol may be given, because these habits may make the symptoms worse.
Daily weighing may be recommended. A weight gain of 3 or 4 pounds or more over 1 or 2 days may indicate fluid accumulation. Activity may be restricted as symptoms progress; other patients may need to initiate an exercise program.
Medications for dilated cardiomyopathy may include diuretics, ACE-inhibitors, digitalis, angiotensin II receptor blockers, inotropes, anticoagulants, antiarrhythmics, and beta-blockers.
Some patients may be offered surgical procedures such as the ventricular assist device (VAD), cardiomyoplasty, mitral or tricuspid valve repair, or partial left ventriculectomy. A heart transplant may be considered if heart function is very poor.
Expectations (prognosis)The outcome varies. There is no known cure for idiopathic dilated cardiomyopathy. Some affected individuals remain stable for long periods, some deteriorate gradually, and some deteriorate rapidly.
Calling your health care provider
Call your health care provider if symptoms indicate cardiomyopathy may be present.
Modify risk factors that can be controlled. Eat a generally well-balanced, nutritious diet, exercise to improve cardiovascular fitness, and avoid or minimize smoking and consumption of alcohol. Consult your primary physician if a recent viral infection leaves you very tired.
Update Date: 5/9/2002Elena Sgarbossa, M.D., Department of Cardiology, Rush-Presbyterian St. Luke's Medical Ctr., Chicago, IL. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT