Dilated cardiomyopathy is a disease of the heart muscle that prevents the muscle from producing the normal force of contraction. Therefore the heart cannot pump enough blood to the organs in the body. The heart becomes weaker and the four heart chambers get larger (dilate). These chambers are the atria (upper chambers) and ventricles (lower chambers). The heart muscle may thicken so that it can produce more force to keep blood pumping normally. The heart valves may also be affected as the heart chambers get large, which may worsen the flow of blood. The impaired heart action can affect lungs, liver, and other organs.
More men (about three times as many) than women have cardiomyopathy, and more African Americans (about three times) than whites.
The cause is usually unknown. Factors that damage the heart muscle and lead to heart failure can cause it. These factors include coronary artery disease, poorly controlled diabetes, anemia, and valvular heart disease. Harmful chemicals (such as alcohol), infections, medications, cocaine, heroin, and some connective tissue diseases may also cause it. Cardiomyopathy often cannot be prevented, but avoiding harmful chemicals such as alcohol may reduce the risk of getting it.
Most people feel tired (fatigue), less able to exercise, or short of breath. Swelling of the legs or feet, chest pain, fast heart beat, and palpitations (feeling that the heart skips beats) may also occur.
The health care provider will ask about symptoms, do a complete physical examination, and order tests. Electrocardiography (ECG) and chest x-rays, which can show an enlarged heart, will be done. The health care provider will suggest seeing a heart specialist (cardiologist) for additional tests. Echocardiography (ultrasound examination of the heart) or angiography (special x-ray examination to check blood flow through the heart) may be done to determine how much damage is present.
Therapy is aimed at relieving symptoms and correcting abnormal heart rhythms (arrhythmias). Lowering salt intake and resting are important. A heart valve operation may be needed for damaged valves. If the cause of the cardiomyopathy is known, that condition is treated. The health care provider may prescribe medicines to control the heart rhythm (antiarrhythmics) and dilate blood vessels (vasodilators), water pills (diuretics), and nutritional supplements. A cardioverter defibrillator may be inserted in the chest in people responding poorly to medications. If the heart’s pumping action is seriously impaired and symptoms of heart failure get worse, heart transplantation can be considered for young people.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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