Dilated cardiomyopathy or DCM (also known as congestive cardiomyopathy), is a disease of the myocardium (the muscle of the heart) in which a portion of the myocardium is dilated, often without any obvious cause. About one in three cases of congestive heart failure (CHF) is due to dilated cardiomyopathy. ^[1] The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Myocardium is the muscular tissue of the heart. ... A top-down view of skeletal muscle Muscle is contractile tissue of the body and is derived from the mesodermal layer of embryonic germ cells. ... The heart and lungs, from an older edition of Grays Anatomy. ... Congestive heart failure (CHF), also called congestive cardiac failure (CCF) or just heart failure, is a condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood throughout the body. ...

A cardiomyopathy is any disease that primarily affects the muscle of the heart. In DCM, left and/or right ventricular systolic pump function of the heart is impaired, leading to progressive cardiac enlargement and hypertrophy, a process called remodeling. ^[2] Systolic is the adjective form of systole, typically referring to the contraction activity of the heart. ... Hypertrophy is the increase of the size of an organ. ...

Dilated cardiomyopathy is the most common form of cardiomyopathy. It occurs more frequently in men than in women, and is most common between the ages of 20 and 60 years.^[3]

Etiology

Although no cause is apparent in many cases, dilated cardiomyopathy is probably the end result of myocardial damage produced by a variety of toxic, metabolic, or infectious agents. It may be the late sequel of acute viral myocarditis, possibly mediated through an immunologic mechanism. Alcohol abuse is also strongly associted with the development of dilated cardiomyopthy in some cases. Autoimmune mechanisms are also suggested as a cause for dilated cardiomyopathy.^[4] Etiology (alternately aetiology, aitiology) is the study of causation. ... In medicine (cardiology), myocarditis is inflammation of the myocardium, the muscular part of the heart. ...

A reversible form of dilated cardiomyopahty may be found with alcohol abuse, pregnancy, thyroid disease, cocaine use, and chronic uncontrolled tachycardia. Tachycardia is an abnormally rapid beating of the heart, defined as a resting heart rate of 100 or more beats per minute in an average adult. ...

Genetics

About 20-40% of patients have familial forms of the disease, with mutations of genes encoding cytoskeletal, contractile, or other proteins present in myocardial cells.^[5] The disease is genetically heterogenous, but the most common form of its transmission is an autosomal dominant pattern. Autosomal recessive, X-linked, and mitochondrial inheritance of the disease is also found.^[6] In biology, mutations are changes to the genetic material (usually DNA or RNA). ... The cytoskeleton is a cellular scaffolding or skeleton contained, as all other organelles, within the cytoplasm. ... An autosomal dominant gene is one that occurs on an autosomal (non-sex determining) chromosome. ... In genetics, the term recessive gene refers to an allele that causes a phenotype (visible or detectable characteristic) that is only seen in a homozygous genotype (an organism that has two copies of the same allele). ... Sex-linked genes are those carried on the mammalian X chromosome but not the Y chromosome. ... Mitochondrial diseases are a group of disorders relating to the mitochondria, the organelles that are the powerhouses of the eukaryotic cells that comprise higher-order lifeforms (including humans). ...

Although the disease is more common in African-Americans than in whites, it may occur in any patient population.

Associated symptoms

For many affected individuals, Dilated Cardiomyopathy is a condition which will not limit the quality or duration of life. A minority, however, experience significant symptoms and there is sometimes a risk of sudden death. Evaluation by a cardiologist is recommended to confirm the diagnosis and to assess the outlook and particularly the risk of complications. In some pations symptoms of left- and right-sided congestive heart failure develop gradually. Left ventricular dilatation may be present for months or even years before the patient becomes symptomatic.

Vague chest pain may be present, but typical angina pectoris is unusual and suggests the presence of concomitant ischemic heart disease. Syncope due to arrhythmias, and systemic embolism may occur. Ischaemic heart disease is a disease characterized by reduced blood supply to the heart. ... Syncope has two distinct and apparantly unrelated meanings, one in linguistics and another in medicne. ... Cardiac arrhythmia is a group of conditions in which the muscle contraction of the heart is irregular or is faster or slower than normal. ... In medicine, an embolism occurs when an object (the embolus, plural emboli) migrates from one part of the body (through circulation) and cause(s) a blockage (occlusion) of a blood vessel in another part of the body. ...

Physical examination

The patients may present variable degrees of cardiac enlargement, and findings of congestive heart failure. In advance stages of the disease, the pulse pressure is narrowed and the jugular venous pressure is elevated. Third and fourth heart sounds are common. Mitral or tricuspid regurgitation may occur, presented by systolic murmurs upon auscultation (see mitral regurgitation and tricuspid insufficiency for more details about the findings). Congestive heart failure (CHF), also called congestive cardiac failure (CCF) or just heart failure, is a condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood throughout the body. ... Pulse pressure is the change in blood pressure seen during a contraction of the heart. ... The jugular venous pressure (JVP, sometimes referred to as jugular venous pulse) is the indirectly observed pressure over the venous system. ... Anterior (frontal) view of the opened heart. ... In anatomy, the heart valves are valves in the heart that prevent blood from flowing the wrong way. ... Regurgitation is the passive flow of stomach contents back into the esophagus and mouth. ... Murmur has a number of meanings, including the following: Murmur To complain in low mumbling tones; grumble. ... Auscultation is the technical term for listening to the internal sounds of the body, usually using a stethoscope. ... Mitral regurgitation (MR), also known as mitral insufficiency, is the abnormal leaking of blood through the mitral valve, from the left ventricle into the left atrium of the heart. ...

Laboratory examinations

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. Frontal chest X-ray. ... Pleural effusion Chest x-ray of a pleural effusion. ...

The electrocardiogram often shows sinus tachycardia or atrial fibrillation, ventricular arrhythmias, left atrial abnormality, and sometimes intraventricual 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. Lead II An electrocardiogram (ECG or EKG, abbreviated from the German Elektrokardiogramm) is a graphic produced by an electrocardiograph, which records the electrical voltage in the heart in the form of a continuous strip graph. ... Sinus tachycardia is a rhythm with elevated rate of impulses originating from the SA node, defined as a rate greater than 100 beats/min in an average adult. ... Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). ... Cardiac arrhythmia is a group of conditions in which the muscle contraction of the heart is irregular or is faster or slower than normal. ... The echocardiogram is an ultrasound of the heart. ... In cardiovascular physiology, ejection fraction (Ef) is the fraction of blood pumped out of a ventricle with each heart beat. ... Catheter disassembled In medicine, a catheter is a tube that a health professional may insert into part of the body. ... A coronary catheterization is a minimally invasive procedure to access the coronary circulation and blood filled chambers of the heart using a catheter. ...

Treatment

Years ago the statistic was that the majority of patients, particularly those over 55 years of age, died within 3 years of the onset of symptoms – and such figures can still be found in some textbooks. The situation 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. Congestive heart failure (CHF), also called congestive cardiac failure (CCF) or just heart failure, is a condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood throughout the body. ... A cardiac arrhythmia, also called cardiac dysrhythmia, is a disturbance in the regular rhythm of the heartbeat. ... Bradycardia, as applied in adult medicine, is defined as a resting heart rate of under 60 beats per minute, though it is seldom symptomatic until the rate drops below 50 beat/min [1]. Trained athletes tend to have slow resting heart rates, and resting bradycardia in athletes should not be...

Patients are given the standard therapy for heart failure, 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. Angiotensin converting enzyme Angiotensin-Converting Enzyme (ACE, EC 3. ... A diuretic is any drug that elevates the rate of bodily urine excretion. ... Species About 20 species, including: Digitalis ciliata Digitalis davisiana Digitalis dubia Digitalis ferruginea Digitalis grandiflora Digitalis laevigata Digitalis lanata Digitalis lutea Digitalis obscura Digitalis parviflora Digitalis purpurea Digitalis thapsi Digitalis viridiflora Digitalis is a genus of about 20 species of herbaceous biennials, perennials and shrubs that was traditionally placed in... An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. ... This article is about a medical device which electrically stimulates the heart. ... An implantable cardioverter-defibrillator (ICD) is a device that is implanted under the skin of patients that are at risk of sudden death due to ventricular fibrillation. ...

In patients with advanced disease who are refractory to medical therapy, cardiac transplantation should be considered. An organ transplant is the transplantation of an organ (or part of one) from one body to another, for the purpose of replacing the recipients damaged or failing organ with a working one from the donor. ...

Alternative Treatment

Energy deficiencies at the cellular level cause gradual weakening of the heart muscle. These energy deficits often are a cause of congestive heart failure and many forms of cardiomyopathy. Treatment of a weakened heart muscle involves the use of several different therapies known to boost cardiac energy levels and decrease vascular resistance. Some food supplements are considered to be helpful in supporting and improving cardiomyopathy and congestive heart failure. There are some serious studies that support this approach. The main supplements in this context are: Coenzyme Q10, L-Carnitine, Taurine and D-Ribose. Studies on these supplements, and especially on Coenzyme Q10, can be easily found on the Internet(search for cardiomyopathy+supplement name). Coenzyme Q (CoQ), also known as ubiquinone or ubiquinol, is a biologically active quinone with an isoprenoid side chain, related in structure to vitamin K and vitamin E. The oxidized structure of CoQ, or Q, is given here: The various kinds of Coenzyme Q can be distinguished by the number... Categories: Amino acids | Biochemistry stubs ... Taurine (from taurus = bull, as it was discovered in ox (Bos taurus) bile) or 2-aminoethanesulfonic acid is an acidic chemical substance found in high abundance in the tissues of many animals (metazoa), especially sea animals. ... Coenzyme Q (CoQ), also known as ubiquinone or ubiquinol, is a biologically active quinone with an isoprenoid side chain, related in structure to vitamin K and vitamin E. The oxidized structure of CoQ, or Q, is given here: The various kinds of Coenzyme Q can be distinguished by the number...

Dilated cardiomyopathy in dogs

Dilated cardiomyopathy is a heritable disease in some dog breeds, including the Boxer, Dobermann, and St Bernard. Treatment is based on medication, including ace inhibitors, loop diuretics and phosphodiesterase inhibitors. Boxer redirects here; for other meanings of boxer, see Boxer (disambiguation). ... The Dobermann (alternatively spelled Doberman in North America) or Doberman Pinscher is a breed of domestic dog. ... Wikimedia Commons has media related to: St. ...

References

1. ^ Harrison's Principles of Internal Medicine, 16th edition. Kasper, Braunwald, Fauci, Hauser, Longo, Jameson. ISBN 0-07-139140-1
2. ^ Harrison's Principles of Internal Medicine, 16th edition. Kasper, Braunwald, Fauci, Hauser, Longo, Jameson. ISBN 0-07-139140-1
3. ^ Robbins Basic Pathology, 7th edition. Kumar, Cotran, Robbins. ISBN 0-7216-9274-5
4. ^ San Martin MA, Garcia A, Rodriguez FJ, Terol I. Dilated cardiomyopathy and autoimmunity: an overview of current knowledge and perspectives. Rev Esp Cardiol. 2002 May;55(5):514-24. PMID 12015932
5. ^ Ross J Jr. Dilated cardiomyopathy: concepts derived from gene deficient and transgenic animal models. Circ J. 2002 Mar;66(3):219-24. PMID 11922267
6. ^ Schonberger J, Seidman CE. Many roads lead to a broken heart: the genetics of dilated cardiomyopathy. Am J Hum Genet. 2001 Aug;69(2):249-60. Epub 2001 Jul 6. PMID 11443548