It occurs mainly in adults 20 to 60 years of age. It affects the ventricles and atria of the heart, and the lower and upper chambers of the heart, respectively.
Frequently, the disease begins in the left ventricle, the main pumping chamber of the heart. The heart muscle begins to dilate, stretching and becoming thinner.
As a result, the interior of the chamber enlarges. The problem often spreads to the right ventricle and then to the atria.
As the chambers of the heart dilate, the heart muscle does not contract normally and can not pump blood very well.
Heart failure occurs as the heart weakens. Common symptoms of heart failure include shortness of breath, fatigue, and swelling of the ankles, feet, legs, abdomen, and veins in the neck.
Dilated cardiomyopathy can also cause problems in the heart valves, arrhythmias (irregular heartbeats), and blood clots in the heart.
Other names for dilated cardiomyopathy:
- Alcoholic cardiomyopathy (A term used when excessive use of alcohol causes the disease).
- Congestive cardiomyopathy
- Diabetic cardiomyopathy.
- Familial dilated cardiomyopathy.
- Idiopathic cardiomyopathy
- Ischemic cardiomyopathy (term used when coronary disease, also called coronary artery disease or heart attack, causes the disease. Not all forms of DCM are of ischemic origin).
- Peripartum cardiomyopathy (A term used when the disease develops in a woman shortly before or after birth).
- Primary cardiomyopathy
What causes dilated cardiomyopathy?
Often, the cause of dilated cardiomyopathy is unknown up to a third of the people who have it inherit it from their parents.
Some diseases, conditions, and substances can also cause the disease, such as:
- Coronary heart disease, heart attack, high blood pressure, diabetes, thyroid disease, viral hepatitis, and HIV.
- Infections, especially viral infections, inflame the heart muscle.
- Alcoholism, especially if you also have a poor diet.
- Complications during the last month of pregnancy or within five months after birth.
- Certain toxins like cobalt.
- Certain drugs (such as cocaine and amphetamines) and two drugs are used to treat cancer (doxorubicin and daunorubicin).
- Thyroid disease
Many people with dilated cardiomyopathy have no symptoms. Some only have minors and live everyday life. Others develop symptoms that can get worse as their heart gets sick.
The symptoms of DCM can occur at any age and may include:
- Short of breath.
- Swelling of your legs
- Weight gain.
- Palpitations (flapping in the chest due to abnormal heart rhythms).
- Dizziness or lightheadedness
- Blood clots in the dilated left ventricle due to the accumulation of blood. If a blood clot breaks down, it can lodge in an artery and interrupt blood flow to the brain, causing a stroke.
- Pain or pressure in the chest.
- Sudden death
Your doctor will decide if you have dilated cardiomyopathy after you see things like:
- Your symptoms
- Your family history
- A physical exam
- Blood test.
- An electrocardiogram.
- A chest x-ray.
- An echocardiogram
- A test of physical effort.
- Cardiac catheterization.
- A CT scan.
- An MRI
Another test that is rarely done to find the cause of myocardiopathy is called a myocardial biopsy or heart biopsy. A sample of heart tissue is taken and examined under a microscope.
If you have a family member with dilated cardiomyopathy, ask your doctor if you should have a screening test. Genetic tests may also be available to find abnormal genes.
In the case of dilated cardiomyopathy, its goal is to strengthen the heart and eliminate substances in the bloodstream that enlarge the nature and cause more severe symptoms.
Medications: To control heart failure, most people take drugs, such as:
- ACE inhibitor and ARB.
If you have an arrhythmia (irregular heartbeat), your doctor may give you medicines to control your heart rate or make them less often. Anticoagulants can also be used to prevent blood clots.
According to your doctor’s recommendations, lifestyle changes: you should consume less sodium if you have heart failure. You may be instructed to do aerobic exercise but not do weights.
People with severe dilated cardiomyopathy may need one of the following surgeries:
Cardiac resynchronization with biventricular pacemaker: for some people with DCM, stimulating the right and left ventricles helps the contractions of your heart strengthen. This improves your symptoms and allows you to exercise more.
The pacemaker will also help people with heart block (a problem with the heart’s electrical system) or some bradycardia (slow heart rates).
Implantable cardioverter-defibrillators: are recommended for people at risk of life-threatening arrhythmias or sudden cardiac death.
Constantly monitor the rhythm of your heart. When it finds a fast and abnormal rhythm, it “shocks” the heart muscle in a healthy rhythm.
Surgery: Your doctor may recommend coronary artery disease or valvular heart disease surgery. You may be eligible for one to fix your left ventricle or one that provides a device to help your heart function better.
Heart transplants: are usually only for those with heart failure in the terminal stage. You will go through a selection process.