Dilated cardiomyopathy overview: Difference between revisions
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==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
Dilated cardiomyopathy is most likely to occur between the ages of 20-60, is three times as likely to occur in males over females, and is 2.5 times more likely to occur in African Americans. | Dilated cardiomyopathy is most likely to occur between the ages of 20-60, is three times as likely to occur in males over females, and is 2.5 times more likely to occur in African Americans. | ||
==Natural History, Complications and Prognosis== | |||
There are several prognostic indicators when evaluating dilated cardiomyopathy, the most important one being [[ejection fraction]]. Complications as a result of dilated cardiomyopathy include [[heart failure]], and aortic and [[mitral valve regurgitation]], [[emboli]], [[edema]], [[arrhythmia]]s and [[sudden cardiac arrest]]. | |||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 22:50, 20 January 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in-Chief: Sachin Shah, M.D.
Overview
Dilated cardiomyopathy is a condition of the heart that causes dilation and impaired contraction of the left ventricle (or both ventricles). Impaired contraction is defined as a low ejection fraction (< 40%).
Pathophysiology
Familial traits and mitochondrial inheritance are thought to play a part in the development of idiopathic dilated cardiomyopathy, and the inheritance occurs in an autosomal dominant pattern. Connective tissue disease, and other diseases or toxins that disrupt the tissue of the heart are also implicated in the development of dilated cardiomyopathy.
Causes
There are many causes of dilated cardiomyopathy. The most common cause is idiopathic in 50% of cases. The next most common cause is myocarditis which is responsible for 10% of cases. Other common causes include substance abuse, connective tissue disease, pregnancy, medications, nutritional deficiencies, infiltrative diseases and toxins.
Epidemiology and Demographics
Dilated cardiomyopathy is most likely to occur between the ages of 20-60, is three times as likely to occur in males over females, and is 2.5 times more likely to occur in African Americans.
Natural History, Complications and Prognosis
There are several prognostic indicators when evaluating dilated cardiomyopathy, the most important one being ejection fraction. Complications as a result of dilated cardiomyopathy include heart failure, and aortic and mitral valve regurgitation, emboli, edema, arrhythmias and sudden cardiac arrest.
Diagnosis
History and Symptoms
Common symptoms in the setting of dilated cardiomyopathy include chest pain, cough, fatigue, loss of appetite, 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.
Laboratory Findings
Endomyocardial biopsy 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. Viral titiers (serologies) are often unhelpful and not routinely ordered in clinical practice.