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Dilated cardiomyopathy


Dilated cardiomyopathy is a serious condition in which the heart muscle becomes weakened and loses strength to pump blood throughout the body. The weakened heart cannot pump as much blood out, so more blood remains in the heart after each heartbeat. As greater amounts of blood fill and remain in the heart's lower chambers (ventricles), the ventricles expand. In time, the heart muscle stretches out of shape (dilates) and becomes even weaker.

Most people with dilated cardiomyopathy eventually develop heart failure. Heart failure does not mean the heart stops pumping; rather, it is a condition in which the ventricles are not able to pump enough blood to meet the body's needs for oxygen and nutrients.
What causes dilated cardiomyopathy?

In the majority of cases, the cause of dilated cardiomyopathy is not known (primary or idiopathic dilated cardiomyopathy). In some cases you can inherit the tendency to develop dilated cardiomyopathy from your parents.

There are specific factors that lead to heart muscle damage and possibly dilated cardiomyopathy, including:

    * Myocarditis, inflammation of the heart muscle caused by a virus or an immune system problem. Infection with the human immunodeficiency virus (HIV) can sometimes trigger the development of dilated cardiomyopathy. 1
    * Coronary artery disease (CAD) and heart attack. However, CAD or heart attack does not lead to dilated cardiomyopathy in every case.
    * Excessive alcohol consumption; illegal drugs, such as cocaine; medications, such as chemotherapy or lithium; and toxic metals, such as lead or mercury.
    * Pregnancy. In rare cases dilated cardiomyopathy develops toward the end of pregnancy or during the first 6 months after giving birth (peripartum cardiomyopathy). Why some women develop peripartum cardiomyopathy is not known.

What are the symptoms?

Initially you may not have any symptoms or you may have mild symptoms, such as fatigue or weakness.

Eventually, as your heart muscle weakens, you will develop heart failure and feel shortness of breath, especially with activity; fatigue; difficulty breathing while lying down; and leg swelling. Symptoms can develop gradually, over months or years, or they can develop suddenly, such as after a viral infection or pregnancy.

How is dilated cardiomyopathy diagnosed?

Your health professional will review your medical history and ask about recent illnesses, your alcohol and drug consumption, and your family history of heart disease. Your health professional will do a thorough physical examination, including listening to your heart and lungs and examining your neck, abdomen, and legs for fluid buildup. An electrocardiogram (ECG, EKG), chest X-ray, echocardiogram, routine blood tests, and further tests are usually needed to confirm a diagnosis.

What can I expect with dilated cardiomyopathy?

The underlying cause of dilated cardiomyopathy often affects long-term survival. If the underlying condition is hard to treat, heart failure may progress.

Sudden cardiac death is also a risk for people with dilated cardiomyopathy, especially when some types of arrhythmias, or abnormal heart rhythms, are present. 2

Of the women who develop dilated cardiomyopathy during pregnancy (peripartum cardiomyopathy), about half will recover completely, and the majority of the rest will improve. Once a woman develops peripartum cardiomyopathy, she should not become pregnant again. 3

Improved diagnostic methods are allowing doctors to identify cardiomyopathy earlier in the course of the disease, when it can be better managed.

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