Myocardium

Dilated Cardiomyopathy

search

Dilated Cardiomyopathy

  • See Also
  1. Systolic Dysfunction
  2. Congestive Heart Failure
  3. Cardiomyopathy
  • Epidemiology
  1. Onset age 40-59 years old
  2. Prevalence: 1 in 2500
    1. Leading cause of Heart Transplantation in the United States
  • Pathophysiology
  1. Familial (Autosomal Dominant) in 25-35% of cases
  2. Dilated Cardiomyopathy Definition
    1. Ventricular enlargement AND
    2. Normal left ventricular wall thickness AND
    3. Systolic Dysfunction
  • Causes
  1. See Secondary Cardiomyopathy
  2. Genetic causes account for 30-40% of cases
  3. Other secondary causes include infectious, environmental exposures and systemic conditions
  • Findings
  1. See Congestive Heart Failure
  2. Systolic Dysfunction
  3. Arrhythmias
  4. Thromboembolism
  • Diagnostics
  1. Electrocardiogram (EKG) Findings
    1. Septal Q Waves
    2. Bundle Branch Block
    3. Tachyarrhythmia
    4. Decreased QRS voltage
  2. Echocardiogram
    1. First-line study in suspected Cardiomyopathy
  3. Cardiac MRI Indications
    1. Tissue characterization to define undelying cause and extent including accurate LVEF estimate
    2. Risk stratification for complications
  • Management
  1. See Systolic Dysfunction
  2. Specific treatments for underlying cause if identified
  3. Arrhythmia management
  4. Anticoagulation for Atrial Fibrillation
  5. Consider AICD
  6. Exercise precautions
    1. Moderate intensity aerobic Exercise is safe and encouraged (improves Cardiac Function and quality of life)
    2. Caution with high intensity Exercise (modify in light of individual patient Exercise tolerance)
  • References
  1. Brieler (2017) Am Fam Physician 96(10):640-6 [PubMed]
  2. Coppiano (2026) Am Fam Physician 113(2): 166-73 [PubMed]