Dilated cardiomyopathy history and symptoms

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
Dilated cardiomyopathy history and symptoms On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Dilated cardiomyopathy history and symptoms All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Dilated cardiomyopathy history and symptoms
CDC on Dilated cardiomyopathy history and symptoms
Dilated cardiomyopathy history and symptoms in the news
Blogs on Dilated cardiomyopathy history and symptoms
Directions to Hospitals Treating Dilated cardiomyopathy
Risk calculators and risk factors for Dilated cardiomyopathy history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in-Chief: Sachin Shah, M.D.

Overview

Common symptoms in the setting of dilated cardiomyopathy include chest pain, cough, fatigue, loss of apetite, and shortness of breath. A careful history is important in the setting of dilated cardiomyopathy in order to ascertain the etiology of the cardiomyopathy. The patient needs to be evaluated for a history of coronary artery disease, viral prodrome and infections, chemotherapy, HIV risk factors, pregnancy, medications, toxins, and substance abuse.

History and Symptoms

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.

Symptoms of heart failure are most common. Usually, they develop slowly over time. However, sometimes symptoms start very suddenly and are severe.

Common symptoms are:

• Chest pain or pressure (more likely when you exercise)
• Cough
• Fatigue, weakness, faintness
• Irregular or rapid pulse
• Loss of appetite
• Shortness of breath with activity or after lying down (or being asleep) for a while
• Swelling of feet and ankles (in adults)

The clinical presentation of dilated cardiomyopathy is similar to that heart failure from any cause. Dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, lower extremity edema and orthostasis / syncope are all common findings in dilated cardiomyopathy. In addition, dilated cardiomyopathy may present as palpitations as a result of arrhythmia (ventricular or atrial) with the most common arrhythmia being atrial fibrillation. Dilated cardiomyopathy may also present as sudden cardiac death or as CVA (cerebrovascular accident) or other embolic phenomenon (either from associated atrial fibrillation or from ventricular thrombi as a result of dilated ventricular cavities).

Angina is not a common feature of dilated cardiomyopathy unless the cause is related to coronary artery disease. If angina is present a work up for cardiac ischemia should be undertaken.