Dilated cardiomyopathy
Cardiomyopathy - dilated; Primary cardiomyopathy; Diabetic cardiomyopathy; Idiopathic cardiomyopathy; Alcoholic cardiomyopathyCardiomyopathy is disease in which the heart muscle becomes weakened, stretched, or has another structural problem.
Dilated cardiomyopathy is a condition in which the heart muscle becomes weakened and enlarged. As a result, the heart cannot pump enough blood to the rest of the body.
There are many types of cardiomyopathy. Dilated cardiomyopathy is the most common form, but it may be the result of different underlying conditions. Some health care providers use the term to indicate a specific condition, called idiopathic dilated cardiomyopathy. There is no known cause for this type of dilated cardiomyopathy.
Causes
The most common causes of dilated cardiomyopathy are:
- Heart disease caused by a narrowing or blockage in the coronary arteries
- Poorly controlled high blood pressure
There are many other causes of dilated cardiomyopathy, including:
- Alcohol or cocaine (or other illegal drug) use (usually heavy use for a prolonged time)
- Diabetes, thyroid disease, or hepatitis
- Medicines that can be toxic to the heart, such as certain medicines used to treat cancer
- Abnormal heart rhythms in which the heart beats very fast for a long period of time
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Autoimmune illnesses
Autoimmune illnesses
An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...
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Infections that involve the heart muscle
Infections that involve the heart muscl
Myocarditis is inflammation of the heart muscle. The condition is called pediatric myocarditis when it occurs in children.
Read Article Now Book Mark Article - Heart valves that are either too narrow or too leaky
- During the last month of pregnancy, or within 5 months after the baby is born
Within 5 months after the baby is born
Peripartum cardiomyopathy is a rare disorder in which a pregnant woman's heart becomes weakened and enlarged. It develops during the last month of p...
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This condition can affect anyone at any age. However, it is most common in adult men.
Symptoms
Symptoms of heart failure are most common. They most often develop slowly over time. However, sometimes symptoms start very suddenly and may be severe.
Common symptoms are:
- Chest pain or pressure (more likely with exercise)
- Cough
- Fatigue, weakness, faintness
- Irregular or rapid pulse
- Loss of appetite
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Shortness of breath with activity or after lying down (or being asleep) for a while
Shortness of breath
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
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Swelling of feet and ankles
Swelling of feet
Painless swelling of the feet and ankles is a common problem, especially among older people. Abnormal buildup of fluid in the ankles, feet, and legs ...
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Exams and Tests
During the exam, the provider may find:
- The heart is enlarged.
- Lung crackles (a sign of fluid buildup), heart murmur, or other abnormal sounds.
- The liver is possibly enlarged.
- Neck veins may be bulging.
A number of laboratory tests may be done to determine the cause:
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Antinuclear antibody (ANA), erythrocyte sedimentation rate (ESR), and other tests to diagnose autoimmune illnesses
Antinuclear antibody
The antinuclear antibody panel is a blood test that looks at antinuclear antibodies (ANA). ANA are antibodies produced by the immune system that bind...
Read Article Now Book Mark ArticleErythrocyte sedimentation rate
ESR stands for erythrocyte sedimentation rate. It is commonly called a "sed rate. "It is a test that indirectly measures the level of certain protei...
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- Iron tests of the blood
- Serum TSH and T4 test to identify thyroid problems
TSH
A TSH test measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland. It prompts the thyroid g...
Read Article Now Book Mark ArticleT4
T4 (thyroxine) is the main hormone produced by the thyroid gland. A laboratory test can be done to measure the amount of free T4 in your blood. Fre...
Read Article Now Book Mark Article - Tests for amyloidosis (blood, urine)
Amyloidosis
Cardiac amyloidosis is a disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue. These deposits make it hard for the heart...
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Heart enlargement or other problems with the structure and function of the heart (such as weak squeezing) may show up on these tests. They may also help diagnose the exact cause of the problem:
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Echocardiogram (ultrasound of the heart)
Echocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
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Cardiac stress tests
Cardiac stress tests
Stress echocardiography is a test that uses ultrasound imaging to show how well your heart muscle is working to pump blood to your body while you exe...
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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Coronary angiogram to look at blood flow through the heart arteries to the heart muscle
Coronary angiogram
Coronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart....
Read Article Now Book Mark Article - Cardiac catheterization to measure pressures in and around the heart
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CT scan of the heart
CT scan of the heart
A computed tomography (CT) scan of the heart is an imaging method that uses x-rays to create detailed pictures of the heart and its blood vessels. Th...
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MRI of the heart
MRI of the heart
Heart magnetic resonance imaging is an imaging method that uses powerful magnets and radio waves to create pictures of the heart. It does not use ra...
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Nuclear heart scan (scintigraphy, MUGA, RNV, PET scan)
Nuclear heart scan
Nuclear ventriculography is a test that uses radioactive materials called tracers to show the heart chambers. The procedure is noninvasive. The ins...
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Heart biopsy, in which a small piece of heart muscle is removed, may be needed depending on the cause. However, this is rarely done.
Heart biopsy
Myocardial biopsy is the removal of a small piece of heart muscle for examination.
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Things you can do at home to take care of your condition include:
- Know your body, and watch for symptoms that your heart failure is getting worse.
Heart failure
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
Read Article Now Book Mark Article - Watch for changes in your symptoms, heart rate, pulse, blood pressure, and weight.
- Limit how much fluid you drink and how much salt (sodium) you get in your diet (check with your provider about these).
How much fluid you drink
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes fluid t...
Read Article Now Book Mark ArticleHow much salt (sodium)
Too much sodium in your diet can be bad for you. If you have high blood pressure or heart failure, you may be asked to limit the amount of salt (whi...
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Most people who have heart failure need to take medicines. Some medicines treat your symptoms. Others may help prevent your heart failure from becoming worse, or may prevent other heart problems.
Heart failure need to take medicines
Most people who have heart failure need to take medicines. Some of these medicines are used to treat your symptoms. Others may help prevent your he...
Read Article Now Book Mark ArticleProcedures and surgeries you may need include:
- A pacemaker to help treat slow heart rates or help your heartbeat stay in sync
- A defibrillator that recognizes life-threatening heart rhythms and sends an electrical pulse (shock) to stop them
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Heart bypass (CABG) surgery or angioplasty to improve blood flow to the damaged or weakened heart muscle
Heart bypass
Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to go around a blockage to reach your heart.
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For advanced cardiomyopathy:
- A heart transplant may be recommended if standard treatments have not worked and heart failure symptoms are very severe.
- Placement of a ventricular assist device or artificial heart may be considered.
Ventricular assist device
Ventricular assist devices (VADs) help your heart pump blood from one of the main pumping chambers to the rest of your body or to the other side of t...
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Chronic heart failure becomes worse over time. Many people who have heart failure will die from the condition. Thinking about the type of care you may want at the end of life and discussing these issues with loved ones and your health care provider is important.
Care you may want at the end of life
It is important to talk to your health care providers and your family about the kind of end-of-life care you want when you are being treated for hear...
Read Article Now Book Mark ArticleOutlook (Prognosis)
Heart failure is most often a chronic illness, which may get worse over time. Some people develop severe heart failure, in which medicines, other treatments, and surgery no longer help. Many people are at risk for deadly heart rhythms, and may need medicines or a defibrillator.
When to Contact a Medical Professional
Contact your provider if you have symptoms of cardiomyopathy.
Get emergency medical help right away if you have chest pain, palpitations or fainting.
References
Elliott PM, Olivotto I. Diseases of the myocardium and endocardium. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 47.
Hershberger RE. The dilated, restrictive, and infiltrative cardiomyopathies. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 52.
Mann DL. Management of heart failure patients with reduced ejection fraction. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 50.
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Cardiomyopathy overview
Animation
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Heart - section through the middle - illustration
The interior of the heart is composed of valves, chambers, and associated vessels.
Heart - section through the middle
illustration
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Heart - front view - illustration
The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.
Heart - front view
illustration
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Dilated cardiomyopathy - illustration
Dilated cardiomyopathy involves enlargement of the heart muscle and is the most common type of cardiomyopathy. The heart muscle is weakened and cannot pump blood efficiently. Decreased heart function affects the lungs, liver, and other body systems.
Dilated cardiomyopathy
illustration
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Alcoholic cardiomyopathy - illustration
Excessive use of alcohol has a direct toxic effect on the heart muscle cells. The heart muscle becomes weakened and cannot pump blood efficiently. The lack of blood flow affects all parts of the body, resulting in damage to multiple tissues and organ systems. Alcohol may also directly damage the liver.
Alcoholic cardiomyopathy
illustration
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Heart - section through the middle - illustration
The interior of the heart is composed of valves, chambers, and associated vessels.
Heart - section through the middle
illustration
-
Heart - front view - illustration
The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.
Heart - front view
illustration
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Dilated cardiomyopathy - illustration
Dilated cardiomyopathy involves enlargement of the heart muscle and is the most common type of cardiomyopathy. The heart muscle is weakened and cannot pump blood efficiently. Decreased heart function affects the lungs, liver, and other body systems.
Dilated cardiomyopathy
illustration
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Alcoholic cardiomyopathy - illustration
Excessive use of alcohol has a direct toxic effect on the heart muscle cells. The heart muscle becomes weakened and cannot pump blood efficiently. The lack of blood flow affects all parts of the body, resulting in damage to multiple tissues and organ systems. Alcohol may also directly damage the liver.
Alcoholic cardiomyopathy
illustration
Review Date: 2/27/2024
Reviewed By: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.