Causes of Dilated Cardiomyopathy

Dilated cardiomyopathy or DCM is caused when the myocardium of the heart is damaged due to some toxic or infectious element. The fibres of the myocardium may show a change from its original state or from the stage when the myocardial farction had occurred previously. 

The myocardium is the fibrous muscle of the heart. This thick layer lies in between the upper layer of the heart also known as Epicardium and the inner layer also known as the Endocardium. The myocardium helps in the contraction and relaxation of the heart.  When enough blood does not reach to a part of the myocardium, the myocardial farction occur or that the muscles fail to work properly due to lack of oxygen. This occurs due to some kind of blood clotting or due to some kind of virus attack.

Dilated Cardiomyopathy

There are several causes which might lead to dilated cardiomyopathy in a patient. They are:

  • The patient can inherit the illness. Heredity is one of the main causes of dilated cardiomyopathy. The cytoskeletal proteins are formed when the genes get mutated or some other mutation causes the change in the protein that will help in the contraction of the heart muscles.
  • Too much consumption of alcohol. This leads to alcoholism. The toxic effect of alcohol on the heart causes dilated cardiomyopathy. Alcoholism weakens the hearts muscles with time and thus pumping blood becomes difficult for the heart. Due to alcohol abuse, the heart muscles become loose and thin.
  • Another cause of dilated cardiomyopathy is severe coronary artery disease. When such an illness occur, the heart disease spread and caused dilated cardiomyopathy making the heart ischemic.
  • When your thyroid gland is not working properly that is it is not active enough, hypothyroidism occurs. Hypothyroidism can then lead to dilated cardiomyopathy in a patient.
  • Diabetes which causes diabetic cardiomyopathy where the blood flow is disrupted water keeps on being stored in the legs or the lungs.
  • Tuberculosis can cause dilated cardiomyopathy.
  • Any kind of muscular dystrophy which weakens the muscles of the heart.
  • Taking heavy dosages of drugs which are harmful for the heart.
  • Various kinds of serious heart infections.
  • Abnormalities occurring during the functioning of the valves in the heart.
  • If there is rapid contraction of the ventricles also known as premature ventricular contraction then dilated cardiomyopathy can occur in a person.
  • Sometimes dilated cardiomyopathy can occur to women soon after the child birth.

The condition which results inside your heart when you have the dilated cardiomyopathy is very critical. The main ventricle that helps in carrying out the blood pump in your heart gets elongated and loosened and thus the blood circulation is disrupted. Thus the heart is never full of blood or relaxed.

If you study the heart, then you shall see that the heart is divided into 4 chambers. The right and left auricles which are at the top of half the part of the heart and the right and left ventricles which consists of the lower part of the heart. The two main arteries and veins, the Aorta and the Vena Cava which bring in the deoxygenated blood to takes out the oxygenated blood are connected these chambers of the heart.  The Aorta distributes the oxygenated blood to the rest of the body collecting the fresh blood from the left ventricle of the heart. The superior and inferior Vena Cava sends in the deoxygenated blood to the right atrium. From there the blood is oxygenated and passed on to the left ventricle  through various valves. The Cardiac cycle consists of 3 stages:

  • Atrial systole. Here the atria is contracted and the blood passes on from the auricle to the ventricle. The AV valve is opened to allow the flow of blood whereas the semilunar valve is closed so that the blood doesn’t already flow to the Aorta before oxygenation.
  • Ventricular Systole. the ventricles contract to pass the oxygenated blood to the arteries to distribute the blood. Here the semilunar valves open and the AV valves open.
  • Relaxation phase. in this stage the whole heart remains in diastole. The ventricles fill with blood up to 75% almost. They also repolarise to carry out the next contraction.

Now when these ventricles become loose and they fail to contract and allow proper blood flow, the person enters in to dilated cardiomyopathy.

Signs and Symptoms of Dilated Cardiomyopathy

The signs and symptoms of dilated cardiomyopathy is like any other heart disease or they can often be compared to the symptoms of a heart failure:

  • The primary symptom of dilated cardiomyopathy is breathing troubles or shortness of breath.
  • Increase in the heart beat rate causing palpitation can be a sign of dilated cardiomyopathy.
  • Sweating.
  • Feeling dizzy.
  • Fatigue.
  • Gaining weight.
  • Fainting.
  • Sudden heart failure.
  • Clotting of blood in the heart stopping the fresh blood to pass on. Sometimes the clot passes on from the heart and get stuck in any of the arteries can causes a stroke.

If the symptoms of dilated cardiomyopathy are mild in nature then with proper treatment the patient will live a healthy life. Sometimes there are no symptoms and the person feels no disturbances throughout his or her life but when the symptoms become severe and noticeable it is wise to consult a doctor.

Diagnosis of Dilated Cardiomyopathy

There are a lot of things that the doctors will consider while they will find out if you have dilated cardiomyopathy or not. The list of things that will be taken under consideration and shall be checked are:

  • The family history of the patient.
  • The medical history of the patient.
  • The physical exams of the patient.
  • The blood tests.
  • Echocardiogram.
  • X-ray of the chest.
  • Electrocardiogram.
  • MRI (magnetic resonance imaging).
  • CT-Scan.
  • Results of the patient after being passed through stressful exercise.
  • Cardiac catheterization.
  • Myocardial biopsy where the tissue sample is collected from the heart and studies under a microscope.

Once dilated cardiomyopathy is diagnosed in you, things can that further deteriorate your condition will have to be removed from your routine and steps will be taken so that your muscles start functioning normally again. This can only be done when the condition is mild.

Treatment for Dilated Cardiomyopathy

There are several medicines for dilated cardiomyopathy which will be prescribed by the doctors so that there will be no chance for a sudden heart failure. Medicines like the Beta Blocker and ACE inhibitor will be suggested by the doctors. Doctors may also suggest you pills to keep your heart beat at a normal and controlled rate and may ask you to take in blood thinners to avoid clotting.

Attaching a biventricular pacemaker for dilated cardiomyopathy which will resynchronize the movements of the heart muscles. The contractions and relaxations will become smoother and normal again. This will also help heart to avoid a blockage.

Attaching ICD can be a part of treatment for dilated cardiomyopathy. These are also known as Implantable Cardioverter Defibrillators. These constantly supervise the function of the heart. The movement of the muscles are made smoother and the flow of blood id made regular. Patients who are suffering from serious symptoms of the dilated cardiomyopathy and have life risks are helped with ICD.

If the person has the coronary artery disease or any kind of valve dysfunction then surgery is suggested by the doctor. The surgery can either make your ventricle work normally gain or give a device to make the movements of the muscles normal again. For more complicated cases when the patient is in his or her last stage, heart implant is done. This process is very risky and not very healthy for any person.

Depending on the kind of treatment and the stage of your dilated cardiomyopathy, the doctors will be able to tell you about the time you will need to recover.

Prevention of Dilated Cardiomyopathy

There are few preventive measures for dilated cardiomyopathy:

  • Getting treated at an early stage can save you the pain and trouble of the dilated cardiomyopathy. 
  • To prevent dilated cardiomyopathy, a person should exercise regularly and maintain a healthy diet to prevent.
  • You should never gain too much weight and always maintain a healthy weight.
  • Having a healthy lifestyle is very important. Avoid consumption of alcohol.
  • Consume a minimum amount of sodium, that is avoid consumption of a fair amount of salt especially when it is uncooked.

Prognosis/Outlook for Dilated Cardiomyopathy

The outlook or prognosis for dilated cardiomyopathy also depends on whether the illness is severe or mild. If the disease is found at the early stages the prognsis is good. The 5 year term survival rate for the patients is about 50 percent and the 10 year survival rate is 25 percent.

Lifestyle Changes for Dilated Cardiomyopathy

  • If you kind out that you have dilated cardiomyopathy, you must change your lifestyle immediately. You should give up consumption of alcohol. You should avoid consuming food which contains a high amount of fat and oil.
  • Start exercising regularly is the best lifestyle change. You should have a certain amount of time dedicated for some kind of fee hand exercise or walking or swimming daily.
  • Never take up too much of stress and disturb your routine. Also try to maintain a healthy routine with proper amount of rest and healthy food.
  • Never ignore any symptom of dilated cardiomyopathy and get  a thorough check-up at regular intervals.
  • If you are diabetic, then change your food habit drastically and give up anything that contains a fair amount of sweet carbohydrates.

Coping with Dilated Cardiomyopathy

Coping with dilated cardiomyopathy is challenging. If your symptoms are severe, then you have to go under a thorough treatment for dilated cardiomyopathy. You must never lose heart and always try to maintain the routine strictly that the doctor has prescribed. Taking the medicines regularly is very important. Avoid food that contains too much of sodium. Take up on daily exercises. you should always find a good amount of time to rest. During the treatment procedure, you should always co-operate with the doctor. As much as you will try to get better, the sooner you will get better.

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Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: May 25, 2017

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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