Dilated cardiomyopathy (DCM) is the most common type of nonischemic cardiomyopathy. In dilated cardiomyopathy, the heart's ability to pump blood is decreased because the heart's main pumping chamber, the left ventricle, is enlarged, dilated and weak. At first, the chambers of the heart respond by stretching to hold more blood to pump through the body. This helps to strengthen the heart's contraction and keep the blood moving for a short while. With time, the heart muscle walls weaken and are not able to pump as strongly. The kidneys often respond by retaining fluid (water) and sodium. If fluid builds up in the legs, ankles, feet, lungs or other organs, the body becomes congested, and congestive heart failure is the term used to describe this condition.
Many people with dilated cardiomyopathy have no symptoms or only minor symptoms. Other people develop symptoms, which may progress as heart function worsens.Symptoms of dilated cardiomyopathy can occur at any age and may include:
When there is no known cause, the condition is called idiopathic dilated cardiomyopathy. About 1/3 of patients with idiopathic DCM have a family history, called familial dilated cardiomyopathy (ref). Familial DCM is a genetic condition. In rare autosomal dominant inheritance patterns (at least two family member have idiopathic DCM), first degree relatives (parents, siblings, children) have a 50 percent chance of inheriting the condition, and may benefit from risk screening or follow-up by a physician.
DCM is diagnosed based on your medical history, physical exam, and other tests. Specific tests may include blood tests, electrocardiogram (ECG), chest X-ray, echocardiogram, exercise stress test, cardiac catheterization, CT scan, MRI scan, and radionuclide studies.
Occasionally, a myocardial biopsy may be performed to determine the cause of cardiomyopathy. During a myocardial biopsy, small tissue samples are taken from the heart and examined under a microscope to determine the cause of the cardiomyopathy.
Family members with familial idiopathic DCM should be screened for DCM. Testing would be the same as mentioned above (medical history, physical exam, ECG, echocardiogram, etc.). Genetic testing is available to identify abnormal genes; researchers are looking into identifying abnormal genes. You should speak to your doctor about family screening.
Treatment of cardiomyopathy is aimed at treating the cause of heart failure whenever possible. Once diagnosed, the primary goal is to improve cardiac function and reduce symptoms. Patients usually take several medications to treat DCM. Doctors also recommend lifestyle changes that decrease symptoms and hospitalizations, and improve quality of life.
Medications are used for two reasons:
To manage heart failure, most people improve by taking a beta-blocker and ACE inhibitor even when not having symptoms. If symptoms occur and/or worsen,digoxin, diuretics, and aldosterone inhibitors may be added. Other medications will be added as needed. For example, if you have an arrhythmia, your doctor may give you a medication to control your heart rate or lessen the occurrence of arrhythmia. Or, blood thinners may be used to prevent blood clots from occurring. Your doctor will discuss what medications are best for you.
Both devices may be combined in a single unit, usually labeled CRT-D.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 04/29/2019