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   Image          = 1151.jpg|   
   Image          = 1151.jpg|   
   Caption        = Dilated Cardiomyopathy: Gross dilated left ventricle with marked endocardial sclerosis <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>|
   Caption        = Dilated Cardiomyopathy: Gross dilated left ventricle with marked endocardial sclerosis <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>|
  DiseasesDB    = 3066 |
  ICD10          = {{ICD10|I|42|0|i|30}} |
  ICD9          = {{ICD9|425.4}} |
  ICDO          = |
  OMIM          = 212110 |
  MedlinePlus    = 000168 |
  eMedicineSubj  = |
  eMedicineTopic = |
  eMedicine_mult = |
  MeshID        = D002311 |
}}
}}
{{Dilated cardiomyopathy}}
{{Dilated cardiomyopathy}}


{{CMG}}; '''Associate Editor-in-Chief:''' Sachin Shah, M.D.
'''For patient information, click [[Dilated cardiomyopathy (patient information)|here]]'''


{{SK}} DCM; congestive cardiomyopathy
{{CMG}}; {{AE}}{{AIA}}; Sachin Shah, M.D.
 
{{SK}} Congestive cardiomyopathy; DCM


==[[Dilated cardiomyopathy overview|Overview]]==
==[[Dilated cardiomyopathy overview|Overview]]==


==Causes==
==[[Dilated cardiomyopathy historical perspective|Historical Perspective]]==
 
==[[Dilated cardiomyopathy pathophysiology|Pathophysiology]]==
 
==[[Dilated cardiomyopathy causes|Causes]]==


==Clinical Presentation==
==[[Dilated cardiomyopathy differential diagnosis|Differentiating Dilated cardiomyopathy from other Diseases]]==


==Diagnosis==
==[[Dilated cardiomyopathy epidemiology and demographics|Epidemiology and Demographics]]==


In terms of determining the etiology a careful history is most instrumental.  If the patient has CAD (coronary artery disease) risk factors, known CAD, or angina then a workup for CAD should be undertaken with coronary angiography.  A viral prodrome such as viral URI or viral gastroenteritis may make viral myocarditis as a more likely cause.  If the patient was exposed to chemotherapy such as anthracyclines then this would be the likely cause.  Patients at risk for HIV should undergo testing as HIV can cause a dilated cardiomyopathy.  Peripartum cardiomyopathy most often occurs 1 month prior to expected delivery or 5 months after delivery, so recent childbirth is important information.  Often by 8 months gestational age pregnancy is physically apparent but it is important to rule out pregnancy in women of childbearing age with dilated cardiomyopathy.  Screening questions regarding cocaine or alcohol abuse or other toxin exposure (such as cobalt) should be addressed. 
==[[Dilated cardiomyopathy risk factors|Risk Factors]]==


A review of systems is also helpful in regards to connective tissue disease associated dilated cardiomyopathy (which can be related to SLE (systemic lupus erythematosis), rheumatoid arthritis, sarcoidosis, scleroderma, as well as other connective tissue diseases). 
==[[Dilated cardiomyopathy screening|Screening]]==


A family history also has a great importance in the diagnosis of dilated cardiomyopathy.  It has been suggested that a portion of those patients labeled as "idiopathic" may have a familial form of the disease.  The prevalence of this in the population of patients with dilated cardiomyopathy has been estimated as high as 25%.<ref>Ross J Jr. Dilated cardiomyopathy: concepts derived from gene deficient and transgenic animal models. Circ J. 2002;66:219-24. PMID 11922267</ref>  The majority of these are thought to be related to autosomal dominant transmission, the remaining are thought to be transimtted in an autosomal recessive and X-linked fashion.<ref>Mestroni L; Rocco C; et al. Familial dilated cardiomyopathy: evidence for genetic and phenotypic heterogeneity. Heart Muscle Disease Study Group. J Am Coll Cardiol 1999 Jul;34(1):181-90.</ref>  Mitochondrial inheritance of the disease has also been identified.<ref>Schonberger J, Seidman CE. Many roads lead to a broken heart: the genetics of dilated cardiomyopathy. Am J Hum Genet. 2001;69:249-60. Epub 2001 Jul 6. PMID 11443548</ref>
==[[Dilated cardiomyopathy natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


Pericardial effusion may accompany myocarditis but this finding is not specific.  Cardiac MRI as discussed above may be helpful in diagnosing myocarditis.  Endomyocardial biopsy as discussed above has low sensitivy and the findings are also notoriously non-specific.  The findings on biopsy usually involve findings of inflammation and specific pathogens are unlikely to be identified.  There may be an increased yield to using MRI to target endomyocardial biopsy as described above.  Viral titiers (serologies) are often unhelpful and not routinely ordered in clinical practice.
==Diagnosis==


==Prognosis==
[[Dilated cardiomyopathy history and symptoms|History and Symptoms]] | [[Dilated cardiomyopathy physical examination|Physical Examination]] | [[Dilated cardiomyopathy laboratory findings|Laboratory Findings]] | [[Dilated cardiomyopathy electrocardiogram|Electrocardiogram]] | [[Dilated cardiomyopathy chest x ray|Chest X-Ray]] | [[Dilated cardiomyopathy CT|CT]] | [[Dilated cardiomyopathy MRI|MRI]] | [[Dilated cardiomyopathy echocardiography|Echocardiography]] | [[Dilated cardiomyopathy other imaging findings|Other Imaging Findings]] | [[Dilated cardiomyopathy genetic testing|Genetic testing]] | [[Dilated cardiomyopathy other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==


==Related chapters==
[[Dilated cardiomyopathy medical therapy|Medical Therapy]] | [[Dilated cardiomyopathy surgery|Surgery]] | [[Dilated cardiomyopathy primary prevention|Primary Prevention]] | [[Dilated cardiomyopathy secondary prevention|Secondary Prevention]] | [[Dilated cardiomyopathy cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Dilated cardiomyopathy future or investigational therapies|Future or Investigational Therapies]]
 
==Case Studies==
 
[[Dilated cardiomyopathy case study one|Case #1]]
 
==Related Chapters==


* [[Cardiomyopathy]]
* [[Cardiomyopathy]]
* [[Hypertrophic cardiomyopathy]]
* [[Hypertrophic cardiomyopathy]]
* [[Stress cardiomyopathy]]
* [[Anticoagulation in patients with dilated cardiomyopathy]]
* [[First degree AV block]]
* [[Second degree AV block]]
* [[Beriberi heart disease]]


==Resources==
* [http://www.cardiomyopathy.org/html/which_card_dcm.htm Cardiomyopathy Association: Dilated cardiomyopathy]
* [http://www.childrenscardiomyopathy.org Children's Cardiomyopathy Foundation]
==References==
{{Reflist|2}}
{{clr}}
{{Circulatory system pathology}}
{{Circulatory system pathology}}


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[[Category:Cardiomyopathy]]
[[Category:Cardiomyopathy]]
[[Category:Cardiology]]
[[Category:Cardiology]]
 
[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date]]
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{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
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Latest revision as of 21:11, 12 December 2019

Dilated cardiomyopathy
Dilated Cardiomyopathy: Gross dilated left ventricle with marked endocardial sclerosis
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

Dilated cardiomyopathy Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Classification

Causes

Differentiating Dilated cardiomyopathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Risk calculators and risk factors for Dilated cardiomyopathy

For patient information, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdelrahman Ibrahim Abushouk, MD[2]; Sachin Shah, M.D.

Synonyms and keywords: Congestive cardiomyopathy; DCM

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Dilated cardiomyopathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X-Ray | CT | MRI | Echocardiography | Other Imaging Findings | Genetic testing | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

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