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Dilated Cardiomyopathy

Definition


Disease: Dilated Cardiomyopathy Dilated Cardiomyopathy
Category: Cardiovascular diseases

Disease Definition:

Dilated cardiomyopathy is a disease of the heart muscle (myocardium) initially affecting the heart’s main pumping chamber, the left ventricle, that becomes dilated and unable to pump blood to the body with as much force as a healthy heart can. This condition doesn’t have to result in symptoms but it could be life-endangering for certain people. Heart failure, which is the inability of the heart to supply the body’s tissue and organs with enough blood, is a common result of dilated cardiomyopathy. The disease might additionally result in arrhythmias, blood clots or abrupt death. Everyone at any age might be affected with dilated cardiomyopathy, even infants and children, though it is most likely to affect middle-aged people.
 

Work Group:


Symptoms, Causes

Symptoms:

When dilated cardiomyopathy causes heart failure or arrhythmias, signs and symptoms might be apparent, such as:

 

  • Breathlessness (dyspnea) when being active or lying down
  • Ascites, which is swelling of the abdomen
  • Weakness and fatigue
  • Swelling (edema) in the legs, feet and ankles
  • Decreased ability to exercise
  • Sensation of quick, fluttering or pounding heartbeats (palpitations)
  • Abrupt weight gain from liquid retention
  • Reduced alertness or difficulty focusing
  • Lack of appetite and nausea
  • Lightheadedness, dizziness or fainting
  • Cough or wheezing that remains for a long period of time

 

A doctor should be contacted in the case of experiencing breathlessness or other symptoms of dilated cardiomyopathy. When there’s pain in the chest that lingers for more than a few minutes or when experiencing severe difficulty breathing, emergency medical care should be contacted. In case this condition runs in the family, one should be screened for dilated cardiomyopathy.
Early detection might be of great help for those who have inherited types of dilated cardiomyopathy but have no apparent signs or symptoms.
 

Causes:

As mentioned before, when the left ventricle, which is the heart’s main pumping chamber, doesn’t pump as efficiently as a healthy heart, dilated cardiomyopathy occurs. The muscles of the left ventricle stretch and become thinner (dilate). This dilating results in the weakening of the heart muscle, and the condition could end up causing heart failure over time.

 

Reasons underlying cardiomyopathy are usually not certain and the reason behind dilated cardiomyopathy can’t be discovered in many cases. Idiopathic dilated cardiomyopathy is the name of those cases. Many genes that are related to dilated cardiomyopathy have been discovered by researchers who are continuing to search for more. 
 

Complications

Complications:

Some of the complications that may result from the enlargement of the left ventricle and its inability to pump blood efficiently include:

 

Heart failure:

Dilated cardiomyopathy could result in heart failure by causing poor blood flow from the left ventricle.

 

Heart valve regurgitation:

Due to the enlargement of the left ventricle, it may be more difficult for the the heart valves to close, resulting in a backward flow of blood, which makes the heart pump in a less effective way contributing to an eventual heart failure.

 

Edema:

Since the heart can’t pump as effectively as a healthy heart, dilated cardiomyopathy could result in fluid accumulation in the lungs, legs, feet (edema) and abdomen.

 

Abnormal heart rhythm (arrhythmias):

Heart rhythm problems (arrhythmia) could be the result of changes in heart structure and changes in pressure on the heart’s chambers could result in.

 

Sudden cardiac arrest:

The heart may suddenly stop beating due to dilated cardiomyopathy.

 

Embolism:

Pooling of blood (stasis) in the left ventricle could contribute to blood clots (emboli) that might go into the bloodstream, cutting off the blood supply to vital organs and resulting in heart attack, stroke or damage to other organs.
 

Treatments:

Treatment for dilated cardiomyopathy aims at treating the underlying cause in case it is certain, decrease symptoms, prevent further heart damage and improve blood flow.

 

MEDICATIONS:

Dilated cardiomyopathy is often treated with the use of a combination of medications. Two or more of these medications might be required depending on the symptoms. There are many effective kinds of medications that are able to treat heart failure and dilated cardiomyopathy, such as:

 

Angiotensin-converting enzyme (ACE) inhibitors:

Some examples are captopril, enalapril and lisinopril. These medications help people who are suffering from dilated cardiomyopathy to live longer and feel better. ACE inhibitors are a kind of vasodilator, a medication that widens or dilates blood vessels to lower blood pressure, improve blood flow and reduce the workload on the heart. ACE inhibitors may result in an irritating cough in certain people, but it might be best to bear the cough if possible. Consulting a doctor about its side effects might be important. The cough may go away by switching to another ACE inhibitor or an angiotensin II receptor blocker.

 

Angiotensin II (A-II) receptor blockers (ARBs):

These medications contain several of the useful effects of ACE inhibitors, though they don't result in a remaining cough. They may be an option for people who are unable to stand ACE inhibitors. Some examples are losartan and valsartan.

 

Beta blockers:

Such as carvedilol, bisoprolol and metoprolol. The heart rate might be slowed down with the use of beta blockers, decreasing blood pressure and even preventing certain harmful effects of stress hormones, which are substances produced by the body that could trigger abnormal heart rhythms and make heart failure even worse. Heart function may be improved and the signs and symptoms of heart failure may be decreased with the use of beta blockers.

 

Diuretics:

Usually known as water pills, such as furosemide and bumetanide, these medications enable the patient to more often, preventing fluid from accumulating in the body. Additionally, these medications reduce fluid in the lungs, easing breathing. Supplements of potassium and magnesium minerals might additionally be prescribed since certain diuretics result in the loss of these minerals from the body. Regular blood tests will be performed to monitor the levels of potassium and magnesium in the blood in case someone is taking diuretics.

 

Aldosterone antagonists:

These medications are mainly potassium-sparing diuretics, but they have additional properties that help the heart function more effectively, might reverse scarring of the heart and might help people suffering from severe heart failure live longer. Some examples are spironolactone and eplerenone. Spironolactone is different from other dieuretics in that it could increase the level of potassium in the blood to dangerous levels.

 

Digoxin:

This medication, additionally referred to as digitalis, raises the strength of the heart muscle contractions. It additionally seems to slow the heartbeat, decrease heart failure symptoms, and improve the patient’s ability to live with dilated cardiomyopathy.

 

Anticoagulants:

Warfarin and aspirin are some examples of these medications; they are prescribed to prevent the formation of blood clots.

 

DEVICES:

These are implantable instruments correcting irregular heartbeats, such as:

 

Biventricular pacemakers:

To coordinate contractions between the left and right ventricle, these devices use electrical shocks.

 

Implantable cardioverter-defibrillators (ICDs):

To control abnormal, rapid heartbeats, including those that cause cardiac arrest, these devices monitor heart rhythm and deliver electrical shocks when needed. They could additionally function as pacemakers.

 

HEART TRANSPLANT:

In case medications and other treatments are no longer working, the patient might be a candidate for a heart transplant.
 

Prognosis:

Not available

Expert's opinion

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