Dilated Cardiomyopathy: Causes, Symptoms, Diagnosis and Treatment

It occurs mainly in adults 20 to 60 years of age. It affects the ventricles and atria of the heart, 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, which means it stretches and becomes 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 giving 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 that inflame the heart muscle.
  • Alcoholism, especially if you also have a poor diet.
  • Complications during the last month of pregnancy or within 5 months after birth.
  • Certain toxins like cobalt.
  • Certain drugs (such as cocaine and amphetamines) and two drugs used to treat cancer (doxorubicin and daunorubicin).
  • Thyroid disease
  • Diabetes.

symptom

Many people with dilated cardiomyopathy have no symptoms. Some who only have minors and live a normal 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
  • Fatigue.
  • Weight gain.
  • Fainting.
  • 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 the flow of blood to the brain, causing a stroke.
  • Pain or pressure in the chest.
  • Sudden death

Diagnosis

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.

Treatment

In the case of dilated cardiomyopathy, its goal is to strengthen the heart and eliminate substances in the bloodstream that enlarge the heart and cause more serious symptoms.

Medications: To control heart failure, most people take medications, such as:

  • Beta blocker.
  • ACE inhibitor an ARB.
  • Diuretic.

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.

Changes in lifestyle: if you have heart failure, you should consume less sodium, according to your doctor’s recommendations. You may be instructed to do aerobic exercise, but do not do weights.

Possible procedures:

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 with this helps the contractions of your heart to 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 very fast and abnormal rhythm, it “shocks” the heart muscle in a healthy rhythm.

Surgery: Your doctor may recommend surgery for coronary artery disease or valvular heart disease. You may be eligible for one to fix your left ventricle or one that provides a device to help your heart function better.

Heart transplant: they are usually only for those with heart failure in the terminal stage. You will go through a selection process.

The hearts that can be used are scarce. In addition, he must be sick enough to need a new heart and healthy enough to undergo the procedure.