Dilated Cardiomyopathy

Excerpt

Dilated Cardiomyopathy (DCM) is a disease of the heart muscle characterized by enlargement and dilation of one or both of the ventricles along with impaired contractility defined as left ventricular ejection fraction (LVEF) less than 40%. By definition, patients have systolic dysfunction and may or may not have overt symptoms of heart failure. This disease process can be classified as either primary or secondary DCM. Primary DCM is considered idiopathic and the diagnosis can only be made after excluding secondary causes.

In most cases DCM is progressive, leading to heart failure and death. Without a transplant, the survival rates are poor.

DCM has many causes and all of them affect the ventricular function to a varying degree. While most patients with DCM have symptoms, a few patients may be asymptomatic because of the compensatory mechanisms. The continued enlargement fo the ventricles leads to a decline in ventricular function, followed by conduction system abnormalities, ventricular arrhythmias, thromboembolism, and heart failure. The earlier these patients are identified and treated, the better the prognosis.