Dilated Cardiomyopathy

Aisa Alyanna B. Habib

Dilated Cardiomyopathy

Also called Congestive Cardiomyopathy

Most common type (90% of cases)Characterized by ventricular

chamber enlargement with impaired systolic function.

Ejection fraction <40%

Causes:

Pathophysiology of DCM

Most Common Causes:

Alcohol Beriberi Cocaine, Coxsackie Virus Drugs: Cocaine, Doxorubacin (adriamycin) Pregnancy Idiopathic, Infections (virus) Genetic

• Mnemonics: ABCD PIG

Dilated Cardiomyopathy

Diagnostic Tests

ECG: Non-Specific changes; may show LVH, occasionally LBBB, ventricular & atrial arrhythmias, sinus tachycardia

Chest X-Ray: Multichamber dilatation w/ congestive features

Echocardiography: Multichamber dilatation, LV wall motion abnormalities usually global hypokinesia (diagnostic tool of choice)

Coronary Angiography: Normal coronary arteries Angiography indicated only to rule out ischemic

heart disease Cardiac MRI (involving infiltrative disease)

Clinical Features:

May occur at any ageSlowly progressive signs and symptoms

of CHF (shortness of breath, easy fatigability, & poor exertional capacity)

Pulmonary congestion (Dyspnea, Orthopnea, Rales)

Systemic Congestion (JVD, Hepatomegaly, Edema)

S3 heart soundDeath attributable to progressive cardiac

failure or arrhythmias

Treatment:

Removal of offending agentConventional Therapy for systolic heart

failure (ACE Inhibitors, diuretics, low-dose beta-blockers, and digitalis)

Surgery options:1) Batista procedure2) Mechanical assist device

3) Cardiac transplantation (Best treatment!)4) Others

Some Questions aboutDilated Cardiomyopathy

Questions about DCM

1) What is the most common cause of dilated cardiomyopathy?

A) SmokingB) systolic HTNC) agingD) idiopathicE) LVH

Questions about DCM

1) What is the most common cause of dilated cardiomyopathy?

A) SmokingB) systolic HTNC) agingD) idiopathicE) LVH

Questions about DCM

2) What 2 things that must be present to diagnose dilated cardiomyopathy?

A) LV dilation + RV dilation B) LV dilation + systolic dysfunction C) RV dilation + Right atrial enlargementD) RV dilation + severe diastolic dysfunction

Questions about DCM

2) What 2 things must be present to diagnose dilated cardiomyopathy?

A) LV dilation + RV dilation B) LV dilation + systolic dysfunction C) RV dilation + Right atrial enlargementD) RV dilation + severe diastolic dysfunction

Questions about DCM

3) A 55 yo african american male presents to your clinic with the following physical exam: rales, elevated JVP, S3 gallop, peripheral edema, and a holosystolic musical murmur. What are you suspecting? 

A) dilated cardiomyopathyB) hypertrophic cardiomyopathy C) restrictive cardiomyopathy D) myocardial infarctionE) right sided HF

Questions about DCM

3) A 55 yo african american male presents to your clinic with the following physical exam: rales, elevated JVP, S3 gallop, peripheral edema, and a holosystolic musical murmur. What are you suspecting? 

A) dilated cardiomyopathyB) hypertrophic cardiomyopathy C) restrictive cardiomyopathy D) myocardial infarctionE) right sided HF

Questions about DCM

4) Which of the following ECG findings would you suspect in dilated cardiomyopathy?

A) LBBBB) sinus bradycardiaC) mobitz type IID) RBBBE) mobitz type I

Questions about DCM

4) Which of the following ECG findings would you suspect in dilated cardiomyopathy?

A) LBBBB) sinus bradycardiaC) mobitz type IID) RBBBE) mobitz type I

Questions about DCM

5) What is the diagnostic tool of choice to diagnose a dilated cardiomyopathy?

A) chest xray B) CBCC) EchocardiogramD) Electrocardiogram

Questions about DCM

5) What is the diagnostic tool of choice to diagnose a dilated cardiomyopathy?

A) chest xray B) CBCC) EchocardiogramD) Electrocardiogram

Questions about DCM

6) What is the diagnostic tool of choice for diagnosing infiltrative disease that may cause dilated cardiomyopathy?

A) Electrocardiogram B) chest radiographC) cardiac MRID) cardiac catheterization

Questions about DCM

6) What is the diagnostic tool of choice for diagnosing infiltrative disease that may cause dilated cardiomyopathy?

A) Electrocardiogram B) chest radiographC) cardiac MRID) cardiac catheterization