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Dilated cardiomyopathy is a heart condition under which one of the heart-pumping chambers (left ventricle) enlarges, dilates, and cannot pump enough blood compared to a healthy heart. Dilated cardiomyopathy is a type of cardiomyopathy condition that can cause the heart muscle to thicken, enlarge, or stiff. There are different types of cardiomyopathies, including dilated cardiomyopathy, hypertrophic, arrhythmogenic right ventricular dysplasia, restrictive cardiomyopathy, and transthyretin amyloid cardiomyopathy.
Dilated cardiomyopathy is one of the most common types of cardiomyopathy. The condition may not cause any symptoms, though it can be life-threatening and a common cause of heart failure. The condition can also lead to arrhythmias, heart valve problems, blood clots, or sudden death. Therefore, the primary goal for treating dilated cardiomyopathy is to improve the cardiac function of the heart and reduce the risk of symptoms.
Symptoms of Dilated Cardiomyopathy
Many people with dilated cardiomyopathy don't exhibit any signs or symptoms. Others may notice some symptoms, which may progress once the heart function worsens. Some of the common symptoms of dilated cardiomyopathy include:
- Shortness of breath
- Fatigue
- Unexplained weight gain
- Heart palpitations
- Swelling in legs
- Dizziness
- Chest pain
- Heart murmurs
- Abnormal heart rhythms
- Congestion
- Inability to exercise
Causes of Dilated Cardiomyopathy
The dilated cardiomyopathy causes are still not known at the moment. However, researchers believe that it may be inherited. Apart from this, there are other things that can cause dilated cardiomyopathy. These include:
- Diabetes
- Obesity
- High blood pressure
- Excess iron in the heart
- Alcohol abuse
- Arrhythmias
- Illegal drugs like cocaine
- Exposure to toxins
- Heart valve diseases
- Thyroid
- Women after childbirth
- Certain viral infections of the heart
- Coronary artery disease
Dilated Cardiomyopathy Diagnosis
The doctor may detect dilated cardiomyopathy during a routine physical examination. The doctor may also perform a series of tests to confirm whether the patient is suffering from this condition or not. These may include:
- Electrocardiogram (ECG or EKG): ECG or EKG is used to record the heart's electrical signals. The test is helpful to identify whether there is some problem with the left ventricle or any sign of arrhythmia.
- Chest X-ray: This test takes images of the heart and lungs to check the heart structures and size.
- Echocardiogram: This is the preliminary test done for detecting dilated cardiomyopathy. Sound waves are used to create images of the heart. This allows the doctor to see whether the left ventricle is enlarged and blood flow status.
- Blood Tests: The tests are performed to check whether the patient is suffering from other conditions like a metabolic disorder or an infection that may cause dilated cardiomyopathy.
- Myocardial biopsy: In rare cases, a myocardial biopsy may be performed to diagnose dilated cardiomyopathy. During the procedure, small samples of the tissues are taken and examined under a microscope to determine the cause.
- Cardiac catheterisation: In Cardiac catheterisation, a catheter is inserted into a blood vessel and guided to the heart during the procedure. The doctor then releases a dye that helps map the arteries and heart in X-rays.
- CT scan or MRI: The doctor may also perform some imaging tests to check the heart function and its chambers.
Dilated Cardiomyopathy Treatment
Depending on the condition and severity of the dilated cardiomyopathy, the dilated cardiomyopathy doctor may suggest the following treatment.
Medications
The doctor may use a combination of medications to treat dilated cardiomyopathy. Some of the
drugs that are used to treat this condition include:
- Angiotensin-converting enzyme (ACE) inhibitors
- Sacubitril/valsartan (Entresto)
- Beta-blockers
- Diuretics
- Digoxin
- Ivabradine
- Blood-thinning medications
- Angiotensin II receptor blockers (ARBs)
Implantable Devices
The doctor may also use implantable devices to treat dilated cardiomyopathy. These may
include:
- Implantable cardioverter defibrillators (ICD)- The ICDs are used with patients who are at
higher risk of arrhythmia. The device monitors the heart rhythm and sends an electrical shock when an abnormal or rapid heartbeat brings it back to its normal position
- Left ventricular assist devices (LVAD)- The doctor may use LVAD to help the heart to pump blood. The mechanical device is usually implanted into the abdomen or chest and attached to the heart. The device assists in pumping the blood and can be used for patients waiting for heart transplant surgery
- Biventricular pacemaker- The device is used to improve the survival rate for dilated cardiomyopathy. The pacemaker sends electrical stimulus to the heart's left and right ventricles to maintain an adequate heart rate
- Surgery- If the treatments mentioned above are ineffective, the doctor may suggest heart transplant surgery to treat dilated cardiomyopathy. The doctor may also recommend surgery for coronary artery disease or valve disease to help improve the symptoms of this condition
Risk Factor of Dilated Cardiomyopathy
The following factors may increase the risk of developing dilated cardiomyopathy:
- Uncontrolled high blood pressure
- Coronary artery disease
- Family history of heart disease
- Inflammation of heart muscles
- Damage to heart muscles from diseases like hemochromatosis
- Long-term alcohol abuse
- Neuromuscular disorders
Prevention of Dilated Cardiomyopathy
There are several ways through which one can prevent dilated cardiomyopathy, including:
- Eat a healthy diet
- Quit Smoking
- Loose weight
- Limit intake of alcohol
- Don't use any illegal drugs
- Control blood pressure and cholesterol levels
- Reduce stress level
- Increase physical activity
- Monitor heart conditions
- Get enough sleep and rest
- Exercise regularly
Complications of Dilated Cardiomyopathy
If untreated, dilated cardiomyopathy may cause the following complications:
- Blood clots: Also known as emboli, the blood clots can form in the left ventricle, cutting off the blood supply to vital organs
- Heart valve regurgitation: The dilated cardiomyopathy causes enlargement of the left
ventricle, which may also cause a backward flow of blood
- Sudden cardiac arrest: Dilated cardiomyopathy can also lead to sudden cardiac arrest, which means the heart stops beating
- Heart failure: This is one of the significant complications of dilated cardiomyopathy. The heart is not able to pump enough blood to the body. The kidney responds to it by accumulating fluid and sodium in the legs, ankles, feet, lungs, or other organs, making the body congested. This leads to heart failure
Prognosis of Dilated Cardiomyopathy
Dilated cardiomyopathy is a serious health condition. The long-term outlook for this condition usually depends on different factors, including how much damage the heart has sustained, the effectiveness of the treatment, and lifestyle changes. The condition can worsen even after proper treatment if the patient fails to follow the proper guidelines given by the expert medical Team.
Review
Reviewed by Dr. Amit Malik, Director and Coordinator, Interventional Cardiology - Cardiac Electrophysiology, Pacemaker.Other Conditions & Treatments
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