Dilated Cardiomyopathy

What do we mean by dilated cardiomyopathy?

One or more chambers of the heart get enlarged than usual, leading to decreased and abnormal contractile function of the heart, hence the heart fails to pump out an adequate amount of blood.

What is the cause of this disease?

Many causes can lead to DCM. Eg viral infections, myopathies, coronary disease, abnormally high heart rates, etc. However, the exact cause cannot be diagnosed and those cases are termed as idiopathic DCM.

What are the symptoms of this disease?

Most common symptoms are shortness of breath, fatigue on exertion, palpitation and chest pain. Sometimes loss of consciousness, swelling of feet, abdomen, etc can occur.

What other complications can arise from this disease?

This sometimes leads to factory complication stroke, arrhythmia (particularly VT), sudden cardiac death, renal failure, peripheral embolization, etc.

What are the treatment options?

If possible find out any reversible cause for coronary artery disease and get that disease treated.

However, in most cases, DCM is non-reversible. In those cases, drugs are the mainstay therapy along with some lifestyle changes. Those with very poor contractile function need AICD or CRT-D implantation in certain cases to prevent sudden cardiac death and also to augment the pumping function of the heart.

How to detect DCM?

Clinical examination, chest X-Ray, ECG, Echocardiography, easily detects DCM. Further investigations like Angiography, Cardiac MRI, Holter Monitoring, etc. can be advised to find out the cause or to detect complication.

What is the result of treatment in such patients?

Those with optimal medical therapy, including proper lifestyle changes, can lead a fairly normal life. However, the exact fate of such patients depends on how low the contractile function is and it is often not quite predictable. Such patients may need intermittent hospitalization for aggravation of symptoms.

What are the lifestyle changes?

Fluid restriction, avoiding salty and fatty foods, avoiding exertion, taking drugs regularly, avoiding any addictions, etc are the usual changes. Some vaccines are also recommended in such patients.

Dr. Siddhartha Mani | Cardiologist | Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata

 

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