The etiology is often idiopathic, while in others it may be related to definable etiological factors such as ethanolrelated myocardial damage or a definite viral myocarditis. It has similar clinical characteristics to dilated cardiomyopathy dcm such as ventricle dilation and systolic dysfunction table 2. Furazolidoneinduced cardiomyopathy is an inexpensive model of dilated congestive cardiomyopathy which rapidly produces a high yield of uniformly affected individuals. Dilated cardiomyopathy dcm, a leading cause of heart failure and heart transplantation in. Dcm usually affects both the left and right sides of the heart.
Although most cases are idiopathic, a number of conditions e. The dilated cardiomyopathy is often assumed as a common pathway. Dilated cardiomyopathy can be genetic or acquired and typically presents. Dilated cardiomyopathy diagnosis show diagnosis of dcm is based on cardiac testing, family history, medical history, and a physical exam. An echocardiogram is the most common test used to diagnose dcm, as the dilation of the ventricle and overall squeeze of the heart can be measured with this test. During recent decades, the genetics, pathophysiology and diagnosis of. Symptoms vary from none to feeling tired, leg swelling, and shortness of breath. A diagnosis of dilated cardiomyopathy requires evidence of dilation and impaired contraction of the left ventricle or both ventricles eg, left ventricular ejection fraction causes of heart disease eg, myocarditis and. After spending some time in practice and working as a house physician, she returned to glasgow as a resident in small animal clinical studies, majoring in cardiology, internal medicine and neurology. Pathophysiology dilated cardiomyopathy pdf semantic scholar. In an analysis of the echocardiographic results of 1100 patients who underwent echocardiogram, 10. In addition, the causes of dcm can vary widely, from genetic causes to toxins and viral infection of the heart myocarditis. Familial dilated cardiomyopathy dcm is a health condition that can run in families that impacts the hearts ability to function how it should due to the heart muscle in the left ventricle becoming thin and weak.
Arke md fnb slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Dilated cardiomyopathy also called idiopathic dilated cardiomyopathy is a condition in which the heart becomes weak and the chambers get large. Discuss the pathophysiology and etiologies of dilated, hypertrophic, and restrictive cardiomyopathy. Some people live long, healthy lives with cardiomyopathy.
Such a functional rather than an aetiological classi. Dilated cardiomyopathy is characterized by ventricular chamber enlargement and systolic dysfunction with greater left ventricular lv. Common to the whole group is a poorly contracting dilated left ventricle with a normal. The pathophysiological entity dilated cardio myopathy dcm is heterogeneous with re gard both to its pathogenesis and its morphol. Accordingly, the list of potential causes of dilated cardiomyopathy is long. As a result, the heart cannot pump enough blood out to the body. The diagnosis and evaluation of dilated cardiomyopathy. Complications can include heart failure, heart valve disease, or an irregular heartbeat causes include genetics, alcohol, cocaine, certain. Pdf an overview of dilated cardiomyopathy researchgate. Dilated cardiomyopathy has many known and probably many unidentified causes see table causes of dilated cardiomyopathy. In cardiomyopathy, the heart muscle becomes thick or rigid, which can weaken the heart.
Cardiomyopathies can be classified as ischemic or nonischemic. Pathophysiology of narrow complex dilated cardiomyopathy. Cardiomyopathy and anaesthesia bja education oxford. Dilated cardiomyopathy merck manuals professional edition.
Typically, both the ventricles and the atria are enlarged and often the muscular walls of the heart are much thinner than normal. Dilated cardiomyopathy dcm dilated cardiomyopathy is rarely seen in cats today. Pathophysiology and treatment of hypertrophic cardiomyopathy mark v. Dilated cardiomyopathy dcm american heart association. Genetic mutations involving genes that encode cytoskeletal, sarcomere, and nuclear envelope proteins, among others, account for up to 35% of cases.
There are many types of cardiomyopathy, with different causes. Nonischemic dilated cardiomyopathy dcm often has a genetic pathogenesis. Dilated cardiomyopathy dcm is a disease of the myocardium characterized by impaired systolic function and dilatation of the left and right ventricles fig. It is a major cause of heart failure and arrhythmia in young adults. Dilated cardiomyopathy is the most common type of cardiomyopathy. Dilated cardiomyopathy dcm hypertrophic cardiomyopathy hcm. Dilated cardiomyopathy dcm, also known as congestive systolic cardiomyopathy, is recognized by impaired systolic function and global dilatation of either one or both ventricular chambers. It is characterized by left ventricular or biventricular dilatation and impaired ventricular contractility2. Dilated cardiomyopathy is characterized by decreased contractile function and loss of myofibril organization.
The ventricle stretches and thins dilates and cant pump blood as well as a healthy heart can. With hypertrophic cardiomyopathy, the heart muscle thickens. A rigorous workup can exclude alternative causes of left ventricular lv dilation and dysfunction, identify etiologies that may respond to speci. Dilated cardiomyopathy dcm is a condition in which the heart becomes enlarged and cannot pump blood effectively. Joanna dukes mcewan joanna dukes mcewan graduated from glasgow in 1986. With restrictive cardiomyopathy, the heart muscle becomes hard and stiff.
Dilated cardiomyopathy is a primary myocardial disease of varied causes1. Whatever may be the etiology, the hallmark of the disorder is a dilated poorly contracting left ventricle, and. Dilated cardiomyopathy is a heart muscle disorder defined by the presence of a dilated and poorly functioning left ventricle in the absence of abnormal loading conditions hypertension, valve disease or ischaemic heart disease sufficient to. Because of the large number of genes and alleles attributed to. Peripartum cardiomyopathy is a rare lifethreatening condition that occurs around the last month of pregnancy and up to six months postpartum. Dilated cardiomyopathy dcm is an important cause of sudden cardiac death scd and heart failure hf and is the leading indication for cardiac transplantation in children and adults worldwide. What is the pathophysiology of dilated cardiomyopathy. Dilated cardiomyopathy dcm is a disease of the heart muscle which causes the heart to weaken and enlarge. Historically, it was linked to a dietary deficiency in taurine, which has been corrected by most cat food manufacturers. Acquired causes include myocarditis and exposure to alcohol, drugs and toxins, and metabolic and endocrine. Dilated cardiomyopathy refers to intrinsic myocardial disease.
Dilated cardiomyopathy dcm is best understood as the. The new, proposed, definition of hypokinetic non dilated cardiomyopathy would identify people with reduced contraction of the heart systolic dysfunction but without dilation of the heart muscle. Pathophysiology of dilated cardiomyopathy full text view. Dilated cardiomyopathy dcm is considered to be familial in. Previously unexplored structural and molecular events that precede and initiate dilation can now be studied in tropomodulinoverexpressing transgenic tot mice exhibiting progressive dilated cardiomyopathy. Many cases of dilated cardiomyopathy dcm are due to idiopathic etiology. Dilated cardiomyopathy may be viewed as a progressive dis order that is initiated after an index event either damages the heart muscle, with. Hypertrophic cardiomyopathy is the most common primary. Types of cardiomyopathy with dilated cardiomyopathy, the heart thins and enlarges. Learn for free about math, art, computer programming, economics, physics, chemistry, biology, medicine, finance, history, and more.
Persons with cardiomyopathy frequently retain excess fluid, resulting in congestion of the lungs, and have symptoms of weakness, fatigue. Cardiomyopathy, any cardiac disease process that results in heart failure due to a decrease in the pumping power of the heart or due to an impairment in the filling of the cardiac chambers. An attempt should be made to detect the presence or absence of risk factors for sudden arrhythmic death. However, in pediatric patients, cardiomyopathies are all considered nonischemic, causing compromises of both structure and function of the heart. Dilated cardiomyopathy is defined by the presence of left ventricular dilatation and contractile dysfunction. Dilated cardiomyopathy circulation research aha journals. Listing a study does not mean it has been evaluated by the u.
Dilated cardiomyopathy the pathophysiological entity dilated cardiomyopathy dcm is heterogeneous with regard both to its pathogenesis and its morphology. Cardiomyopathy in the pediatric patients sciencedirect. By utilising the velocity equation, the pathophysiology of narrow complex cardiomyopathy allows above normal conduction propagation velocities. Dilated cardiomyopathy is characterized by decreased contractile function and. Often, there are ventricular and supraventricular arrhythmias, conduction system abnormalities, and thromboembolism. Dilated cardiomyopathy is a disease of the heart muscle, usually starting in your hearts main pumping chamber left ventricle. There are two pathophysiological theories that allow above normal conduction velocities and failure to. Dilated cardiomyopathy dilated or congestive cardiomyopathy dcm is diagnosed when the heart is enlarged dilated and the pumping chambers contract poorly usually left side worse than right. Cardiomyopathy is the name for diseases of the heart muscle. Hypertrophic cardiomyopathy is the most common primary cardiomyopathy and can cause exertional dyspnea, presyncope, atypical chest pain. Pathophysiology of dilated cardiomyopathy the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Cardiomyopathy knowledge for medical students and physicians.
Dilated cardiomyopathy cardiovascular disorders msd. It affects the hearts ventricles and atria, the lower and upper chambers of the heart, respectively. More than 20 viruses can cause dilated cardiomyopathy. A diagram and echocardiogram comparing a normal heart and a heart with dcm are shown in figure 1a and figure 1b. Scroll down to read the article or download a printfriendly pdf here if the pdf. Dilated cardiomyopathy can appear along a spectrum of no symptoms, subtle symptoms or, in the more severe cases, congestive heart failure chf, which occurs. In rare cases, scar tissue replaces the muscle tissue. The pathophysiology of narrow complex dilated cardiomyopathy is not defined, so therapeutic options are limited. Diagnosis and management of dilated cardiomyopathy heart. Dilated cardiomyopathy is a progressive, usually irreversible, disease causing global systolic contractile dysfunction with heart failure. Sherrid all patients with hypertrophic cardiomyopathy hcm should have five aspects of care addressed. Approach to patient with dilated cardiomyopathy slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Dcm is characterized by a poorly contracting dilated left. Dcm is the most prevalent form of cardiomyopathy with an incidence of one in approximately 2500 individuals.
Dilated cardiomyopathy is defined by the presence of left ventricular dilatation and contractile. Dilated cardiomyopathy symptoms and causes mayo clinic. Because the muscle becomes more thin, the space inside the left ventricle, called the chamber, gets bigger dilated. Learn more about causes, risk factors, screening and prevention, signs and symptoms, diagnoses, and treatments for cardiomyopathy, and how to participate in clinical trials.
In central and south america, chagas disease due to trypanosoma cruzi is the most common infectious cause. Dilated cardiomyopathy dcm is the most common type, occurring mostly in adults 20 to 60. Cardiomyopathy refers to diseases of the heart muscle. One of several phenotypic classifications of cardiomyopathy, dilated cardiomyopathy dcm, is usually progressive and is a leading indication for cardiac transplantation in adults and children. Khan academy is a nonprofit with the mission of providing a free, worldclass education for anyone, anywhere. These diseases enlarge your heart muscle or make it thicker and more rigid than normal. This wellcharacterized model of dilated cardiomyopathy possesses structural and functional similarities to human diseases. Frequently the disease starts in the left ventricle, the hearts main pumping chamber. If you continue browsing the site, you agree to the use of cookies on this website. Cardiomyopathy national heart, lung, and blood institute.