Dilated Congestive Cardiomyopathy - Dilated Cardiomyopathy

The heart is made up of muscle, valves, supporting structures, a conduction system and blood vessels. A cardiomyopathy is any disease of the heart muscle. This term is usually only used when the disease is inside the heart itself, and not due to high blood pressure, clogging of the arteries from atherosclerosis or heart valve problems. In dilated cardiomyopathy, one of the subtypes of this disease, the heart muscle becomes thin and flabby, and the heart becomes enlarged.

What is going on in the body?

This condition makes the heart unable to pump blood effectively. The thin, flabby heart muscle is weak and cannot function properly. This results in symptoms for the affected person.

What are the causes and risks of the condition?

Sometimes the condition is inherited. But in many cases, the cause is unknown. Other possible causes include:

What are the signs and symptoms of the condition?

This is often a disorder that develops slowly over time. An affected person may notice these symptoms:

A physical exam may reveal:

How is the condition diagnosed?

A healthcare provider may suspect this disease after he or she takes the person's health history and does a physical exam. An ECG, or heart tracing, and chest x-ray may show certain changes. Echocardiography, a test that uses sound waves to look at the heart, can show the flabby heart muscle and how poorly it pumps blood. Other special x-ray tests may also be used in some cases. Rarely, a biopsy of the heart muscle is advised. This is a procedure to remove a small piece of heart muscle so that it can be sent to the lab and analyzed.

What can be done to prevent the condition?

In many cases, this disease cannot be prevented. Avoiding alcohol, cocaine, and other toxic agents can prevent some cases.

What are the long-term effects of the condition?

This is a very serious condition with a fairly high risk of death. Unless there is a treatable cause or toxin, little can be done to prolong life. Death usually occurs from heart failure, irregular heartbeats, or blood clots that develop in the heart.

What are the risks to others?

There are no risks to others.

What are the treatments for the condition?

Those with exposure to toxic substances, such as cocaine or alcohol, need to stop the exposure right away. Those with treatable causes, such as hypothyroidism, need treatment of the cause. In these cases, treatment may help the heart get back much of its normal function.

In cases without a treatable cause, heart medications are used to help the heart pump better. Other heart medications help prevent irregular heartbeats, called arrhythmias. Taking water pills, called diuretics, and reducing salt in the diet can help prevent fluid buildup in the body. Affected people need plenty of rest and stress reduction. Exercise is encouraged if the person is able. Severely affected people may need a heart transplant.

What are the side effects of the treatments?

All medications have possible side effects. For instance, diuretics can cause dehydration and salt imbalances. Specific side effects depend on the medications used. A heart transplant is a high risk surgery that may result in bleeding, infection, or death.

What happens after treatment for the condition?

People with this condition, even after the best treatment, often get worse. In fact, many die. Newer heart medications may slow the progression of the condition. After a heart transplant, people need close monitoring and must take powerful medications to prevent rejection of the new heart. People who receive a transplant can expect to live longer than those who don't.

How is the condition monitored?

The medications used to help the heart pump better need to be monitored and often adjusted. After a heart transplant, a person is watched closely to see if his or her body will reject the new heart.

Author:Eric Berlin, MD
Date Written:
Editor:Smith, Elizabeth, BA
Edit Date:06/20/00
Reviewer:Adam Brochert, MD
Date Reviewed:06/01/01

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