CARDIOMYOPATHY, DILATED

Cardiomyopathy is a disease of the heart muscle that prevents the muscle from generating the normal force of contraction. The result is that the heart does not effectively pump blood (heart failure). The cardiac chambers may dilate, which means they enlarge inside. The heart muscle may try to thicken to generate more force to keep blood pumping normally from the heart. The heart valves may become affected as the heart chambers enlarge, which may worsen the flow of blood.

The cause of dilated cardiomyopathy is usually unknown. Factors that damage the heart muscle and lead to heart failure can cause it. Toxins such as alcohol, infections, and some connective tissue diseases may cause cardiomyopathy.

Living With Your Diagnosis

Most persons with this condition experience fatigue, decreased ability to exercise, or shortness of breath. You may have swelling of the legs or feet, chest pain, or palpitations (feeling of the heart beating too fast). Symptoms lead to an examination, which may show an abnormal electrocardiogram (ECG) and a heart that looks enlarged on a chest radiograph (x-ray). The examination may show signs of an enlarged heart and heart failure. Echocardiography (an ultrasound examination of the heart) or angiography (radiographic examination performed to assess blood flow through the heart) is used to assess the pumping function of the heart.

Treatment

Therapy for cardiomyopathy is aimed at the symptoms of the heart failure and abnormal heart rhythms (arrhythmias) that occur. A heart valve operation may be needed if the valves are damaged. If damaged valves are present, antibiotics are prescribed for use before and after dental or surgical procedures. If a cause of cardiomyopathy is known, the patient is treated for that condition. Antiarrhythmic medications are prescribed. If pumping function is seriously decreased and the symptoms of heart failure are worsening, heart transplantation is considered for young patients.

The DOs

Decrease excess sodium (salt) and fluid in your diet.
Take all medications as prescribed.

The DON'Ts

Avoid alcohol consumption.
Avoid strenuous exercise until you have clearance from your physician.

When to Call Your Doctor

If you have new or worsening chest pain, shortness of breath, swelling in the legs, or fainting.

For More Information
Contact the American Heart Association at 1-800-242-8721 and ask for the literature department.

Left: normal heart. Right: dilated cardiomyopathy. (Drawing by David Fisher. From Kinney MR, Packa DR: Andreoli's comprehensive cardiac care, ed 8, St Louis, 1995, Mosby. Used by permission.)

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