Disease: Dilated cardiomyopathy

    Overview

    Dilated cardiomyopathy is a disease of the heart muscle, usually starting in your heart's main pumping chamber (left ventricle). The ventricle stretches and thins (dilates) and can't pump blood as well as a healthy heart can. The term "cardiomyopathy" is a general term that refers to the abnormality of the heart muscle itself.

    Dilated cardiomyopathy might not cause symptoms, but for some people it can be life-threatening. A common cause of heart failure — the heart's inability to supply the body with enough blood — dilated cardiomyopathy can also contribute to irregular heartbeats (arrhythmias), blood clots or sudden death.

    The condition affects people of all ages, including infants and children, but is most common in men ages 20 to 50.

    Source: http://www.mayoclinic.com

    Symptoms

    If you have dilated cardiomyopathy, you're likely to have signs and symptoms of heart failure or arrhythmias caused by your condition. Signs and symptoms include:

    • Fatigue
    • Shortness of breath (dyspnea) when you're active or lying down
    • Reduced ability to exercise
    • Swelling (edema) in your legs, ankles and feet
    • Swelling of your abdomen due to fluid buildup (ascites)
    • Chest pain
    • Extra or unusual sounds heard when your heart beats (heart murmurs)

    When to see a doctor

    If you're short of breath or have other symptoms of dilated cardiomyopathy, see your doctor as soon as possible. Call 911 or your local emergency number if you feel chest pain that lasts more than a few minutes or have severe difficulty breathing.

    If a family member has dilated cardiomyopathy, talk to your doctor about being screened or having family members screened for the condition. Early detection using genetic testing may benefit people with inherited forms of dilated cardiomyopathy who have no apparent signs or symptoms.

    Source: http://www.mayoclinic.com

    Causes

    The cause of dilated cardiomyopathy often can't be determined. However, numerous factors can cause the left ventricle to dilate and weaken, including:

    • Diabetes
    • Obesity
    • High blood pressure (hypertension)
    • Alcohol abuse
    • Certain cancer medications
    • Cocaine use and abuse
    • Infections, including those caused by bacteria, viruses, fungi and parasites
    • Exposure to toxins, such as lead, mercury and cobalt
    • Arrhythmias
    • Complications of late-stage pregnancy

    Source: http://www.mayoclinic.com

    Diagnosis

    Your doctor will take a personal and family medical history. Then, he or she will also do a physical exam using a stethoscope to listen to your heart and lungs, and order tests. Your doctor may refer you to a heart specialist (cardiologist) for testing.

    Tests your doctor might order include:

    • Blood tests. These tests give your doctor information about your heart. They also may reveal if you have an infection, a metabolic disorder or toxins in your blood that can cause dilated cardiomyopathy.
    • Chest X-ray. Your doctor may order a chest X-ray to check your heart and lungs for changes or abnormalities in the heart's structure and size, and for fluid in or around your lungs.
    • Electrocardiogram (ECG). An electrocardiogram — also called an ECG or EKG — records electrical signals as they travel through your heart. Your doctor can look for patterns that may be a sign of an abnormal heart rhythm or problems with the left ventricle. Your doctor may ask you to wear a portable ECG device (Holter monitor) to record your heart rhythm for a day or two.
    • Echocardiogram. This primary tool for diagnosing dilated cardiomyopathy uses sound waves to produce images of the heart, allowing your doctor to see whether your left ventricle is enlarged. This test can also reveal how much blood is ejected from the heart with each beat and whether blood is flowing in the right direction.
    • Exercise stress test. Your doctor may have you perform an exercise test, either walking on a treadmill or riding a stationary bike. Electrodes attached to you during the test help your doctor measure your heart rate and oxygen use.

      This type of test can show the severity of problems caused by dilated cardiomyopathy. If you're unable to exercise, you may be given medication to create stress on your heart.

    • CT or MRI scan. In some situations, your doctor might order one of these tests to check the size and function of your heart's pumping chambers.
    • Cardiac catheterization. For this invasive procedure, a long, narrow tube is threaded through a blood vessel in your arm, groin or neck into your heart. The test enables your doctor to see your coronary arteries on X-ray, measure pressure in your heart and collect a sample of muscle tissue to check for damage that indicates dilated cardiomyopathy.

      This procedure may involve having a dye injected into your coronary arteries to help your doctor study your coronary arteries (coronary angiography).

    • Genetic screening or counseling. If your doctor can't identify the cause of dilated cardiomyopathy, he or she may suggest screening of other family members to see if the disease is inherited in your family.

    Source: http://www.mayoclinic.com

    Complications

    Complications from dilated cardiomyopathy include:

    • Heart failure. Poor blood flow from the left ventricle can lead to heart failure. Your heart might not be able to supply your body with the blood it needs to function properly.
    • Heart valve regurgitation. Enlargement of the left ventricle may make it harder for your heart valves to close, causing a backward flow of blood and making your heart pump less effectively.
    • Fluid buildup (edema). Fluid can build up in the lungs, abdomen, legs and feet (edema).
    • Abnormal heart rhythms (arrhythmias). Changes in your heart's structure and changes in pressure on your heart's chambers can contribute to the development of arrhythmias.
    • Sudden cardiac arrest. Dilated cardiomyopathy can cause your heart to suddenly stop beating.
    • Blood clots (emboli). Pooling of blood (stasis) in the left ventricle can lead to blood clots, which may enter the bloodstream, cut off the blood supply to vital organs, and cause stroke, heart attack or damage to other organs. Arrhythmias can also cause blood clots.

    Source: http://www.mayoclinic.com

    Prevention

    Healthy lifestyle habits can help you prevent or minimize the effects of dilated cardiomyopathy. If you have dilated cardiomyopathy:

    • Don't smoke.
    • Don't drink alcohol, or drink in moderation.
    • Don't use cocaine or other illegal drugs.
    • Eat a healthy diet, especially a low-salt (sodium) diet.
    • Maintain a healthy weight.
    • Follow an exercise regimen recommended by your doctor.
    • Get enough sleep and rest.

    Source: http://www.mayoclinic.com

    Lifestyle and home remedies

    If you have dilated cardiomyopathy, these self-care strategies may help you manage your symptoms:

    • Exercise. Talk to your doctor about what activities would be safe and beneficial for you. In general, competitive sports aren't recommended because they can increase the risk of the heart stopping and causing sudden death.
    • Quit smoking. Your doctor can give you advice on what methods can help you stop.
    • Don't use illegal drugs or drink alcohol excessively. Using cocaine or other illegal drugs can strain your heart. Before you drink alcohol, ask your doctor for advice.
    • Maintain a healthy weight. Extra weight makes your heart work harder. Lose weight if you're overweight or obese.
    • Eat a heart-healthy diet. Eating whole grains and a variety of fruits and vegetables, and limiting salt, added sugar, and cholesterol, saturated fats and trans fats is good for your heart. Ask your doctor for a referral to a dietitian if you need help planning your diet.

    Source: http://www.mayoclinic.com

    Risk factors

    Dilated cardiomyopathy most commonly occurs in men, ages 20 to 50. But it can also occur in women. Other risk factors include:

    • Damage to the heart muscle from a heart attack
    • Family history of dilated cardiomyopathy
    • Inflammation of heart muscle from immune system disorders, such as lupus
    • Neuromuscular disorders, such as muscular dystrophy

    Source: http://www.mayoclinic.com

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