Tuesday, April 19, 2011

Dilated Cardiomyopathy

Dilated cardiomyopathy is a the enlargement of the myocardium, rendering the heart unable to pump blood efficiently. Over time, the decreased heart function can affect the lungs, liver, and other body systems. In dilated cardiomyopathy, it is the heart left ventricle that becomes specially dilated and cannot pump enough blood to supply the body's tissue and organs. Generalized enlargement of the heart is seen upon normal chest X-ray. Pleural effusion may also be noticed, which is due to pulmonary venous hypertension. The electrocardiogram often shows sinus tachycardia or atrial fibrillation, ventricular arrhythmias, left atrial abnormality, and sometimes intraventricular conduction defects and low voltage. Echocardiogram shows left ventricular dilatation with normal or thinned walls and reduced ejection fraction. Cardiac catheterization and coronary angiography are often performed to exclude ischemic heart disease.

The situation with dilated cardiomyopathy has improved dramatically in recent years with drug therapy that can slow down progression and in some cases even improve the heart condition. Death is due to either congestive heart failure or ventricular tachy- or bradyarrhythmias. Patients are given the standard therapy for heart failure, typically including salt restriction, angiotensin-converting enzyme (ACE) inhibitors, diuretics, and digitalis. Anticoagulants may also be used. Alcohol should be avoided. Artificial pacemakers may be used in patients with intraventricular conduction delay, and implantable cardioverter-defibrillators in those at risk of arrhythmia. These forms of treatment have been shown to improve symptoms and reduce hospitalization.