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Dilated cardiomyopathy: Difference between revisions
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'''Dilated cardiomyopathy''' (<abbr>DCM</abbr>) is a form of [[cardiomyopathy]] characterised by dilation of all four heart chambers, in the absence of [[ischaemic heart disease]], [[hypertension]], [[valvular disease]], and [[congenital heart disease]]. The [[ejection fraction]] is <45% and the left ventricular end-diastolic volume is >117% of | <section begin="radiology" />'''Dilated cardiomyopathy''' (<abbr>DCM</abbr>) is a form of [[cardiomyopathy]] characterised by dilation of all four heart chambers, in the absence of [[ischaemic heart disease]], [[hypertension]], [[valvular disease]], and [[congenital heart disease]]. The [[ejection fraction]] is <45% and the left ventricular end-diastolic volume is >117% of predicted based on body surface area. | ||
DCM is the most common cardiomyopathy, affecting 1/250. The prognosis is poor with a 5-year survival rate of 50%. | DCM is the most common cardiomyopathy, affecting 1/250. The prognosis is poor with a 5-year survival rate of 50%.<section end="radiology" /> | ||
== Etiology == | == Etiology == | ||
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== Clinical features == | == Clinical features == | ||
Patients can be asymptomatic. Symptomatic patients have features of right and/or left-sided heart failure, including fatigue, weakness, exercise intolerance, chest pain, palpitations, and tachycardia. | Patients can be asymptomatic. Symptomatic patients have features of right and/or left-sided heart failure, including fatigue, weakness, exercise intolerance, chest pain, palpitations, and tachycardia. | ||
<section begin="radiology" /> | |||
== Diagnosis and evaluation == | == Diagnosis and evaluation == | ||
[[Chest X-ray|X-ray]] shows enlargement of the cardiac silhouette, and possibly signs of pulmonary congestion. [[Echocardiography]] shows dilation of all four chambers, decreased EF, and secondary mitral and tricuspid regurgitation. | [[Chest X-ray|X-ray]] shows enlargement of the cardiac silhouette, and possibly signs of pulmonary congestion. [[Echocardiography]] shows dilation of all four chambers, decreased EF, and secondary mitral and tricuspid regurgitation. | ||
[[Magnetic resonance imaging|MRI]] is the gold standard for evaluation, as it can measure the volumes of the chambers. It’s also helpful in the evaluation of [[myocarditis]], a common cause. | [[Magnetic resonance imaging|MRI]] is the gold standard for evaluation, as it can measure the volumes of the chambers in addition to showing the dilatation. It’s also helpful in the evaluation of [[myocarditis]], a common cause. | ||
<section end="radiology" /> | |||
== Treatment == | == Treatment == | ||
There is no specific treatment for DCM. If there’s an underlying disease, it should be treated. Treatment for [[heart failure]] is often necessary. Implantation of <abbr>[[Implantable cardioverter defibrillator|ICD]]</abbr> is important to prevent [[sudden cardiac death]] by [[Ventricular fibrillation|V-fib]]. Heart transplant is the only curative treatment. | There is no specific treatment for DCM. If there’s an underlying disease, it should be treated. Treatment for [[heart failure]] is often necessary. Implantation of <abbr>[[Implantable cardioverter defibrillator|ICD]]</abbr> is important to prevent [[sudden cardiac death]] by [[Ventricular fibrillation|V-fib]]. Heart transplant is the only curative treatment. | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Internal Medicine (POTE course)]] | [[Category:Internal Medicine (POTE course)]] | ||