Dilated Cardiomyopathy

Aisa Alyanna B. Habib

Dilated Cardiomyopathy
Also called Congestive
Cardiomyopathy
Most common type (90% of cases)
Characterized by ventricular
chamber enlargement with
impaired systolic function.
Ejection fraction <40%

Causes:

Pathophysiology of DCM

Most Common Causes:

Alcohol
Beriberi
Cocaine, Coxsackie Virus
Drugs: Cocaine, Doxorubacin (adriamycin)
Pregnancy
Idiopathic, Infections (virus)
Genetic
Mnemonics: ABCD PIG

Dilated Cardiomyopathy

Diagnostic Tests
ECG: Non-Specific changes; may show LVH,
occasionally LBBB, ventricular & atrial
arrhythmias, sinus tachycardia
Chest X-Ray: Multichamber dilatation w/
congestive features
Echocardiography: Multichamber dilatation, LV
wall motion abnormalities usually global
hypokinesia (diagnostic tool of choice)
Coronary Angiography: Normal coronary arteries
Angiography indicated only to rule out ischemic
heart disease
Cardiac MRI (involving infiltrative disease)

Clinical Features:
May occur at any age
Slowly progressive signs and symptoms of
CHF (shortness of breath, easy fatigability,
& poor exertional capacity)
Pulmonary congestion (Dyspnea,
Orthopnea, Rales)
Systemic Congestion (JVD, Hepatomegaly,
Edema)
S3 heart sound
Death attributable to progressive cardiac
failure or arrhythmias

Treatment:
Removal of offending agent
Conventional Therapy for systolic heart
failure (ACE Inhibitors, diuretics, lowdose beta-blockers, and digitalis)
Surgery options:
1) Batista procedure
2) Mechanical assist device
3) Cardiac transplantation

treatment!)
4) Others

(Best

Some Questions about

Dilated Cardiomyopathy

Questions about DCM

1) What is the most common cause of
dilated cardiomyopathy?
A) Smoking
B) systolic HTN
C) aging
D) idiopathic
E) LVH

Questions about DCM

1) What is the most common cause of
dilated cardiomyopathy?
A) Smoking
B) systolic HTN
C) aging
D) idiopathic
E) LVH

Questions about DCM

2) What 2 things that must be present to
diagnose dilated cardiomyopathy?
A) LV dilation + RV dilation
B) LV dilation + systolic dysfunction
C) RV dilation + Right atrial enlargement
D) RV dilation + severe diastolic
dysfunction

Questions about DCM

2) What 2 things must be present to
diagnose dilated cardiomyopathy?
A) LV dilation + RV dilation
B) LV dilation + systolic dysfunction
C) RV dilation + Right atrial enlargement
D) RV dilation + severe diastolic
dysfunction

Questions about DCM

3) A 55 yo african american male presents
to your clinic with the following physical
exam: rales, elevated JVP, S3 gallop,
peripheral edema, and a holosystolic
musical murmur. What are you suspecting?
A) dilated cardiomyopathy
B) hypertrophic cardiomyopathy
C) restrictive cardiomyopathy
D) myocardial infarction
E) right sided HF

Questions about DCM

3) A 55 yo african american male presents
to your clinic with the following physical
exam: rales, elevated JVP, S3 gallop,
peripheral edema, and a holosystolic
musical murmur. What are you suspecting?
A) dilated cardiomyopathy
B) hypertrophic cardiomyopathy
C) restrictive cardiomyopathy
D) myocardial infarction
E) right sided HF

Questions about DCM

4) Which of the following ECG findings
would you suspect in dilated
cardiomyopathy?
A) LBBB
B) sinus bradycardia
C) mobitz type II
D) RBBB
E) mobitz type I

Questions about DCM

4) Which of the following ECG findings
would you suspect in dilated
cardiomyopathy?
A) LBBB
B) sinus bradycardia
C) mobitz type II
D) RBBB
E) mobitz type I

Questions about DCM

5) What is the diagnostic tool of choice to
diagnose a dilated cardiomyopathy?
A) chest xray
B) CBC
C) Echocardiogram
D) Electrocardiogram

Questions about DCM

5) What is the diagnostic tool of choice to
diagnose a dilated cardiomyopathy?
A) chest xray
B) CBC
C) Echocardiogram
D) Electrocardiogram

Questions about DCM

6) What is the diagnostic tool of choice
for diagnosinginfiltrativedisease that
may cause dilated cardiomyopathy?
A) Electrocardiogram
B) chest radiograph
C) cardiac MRI
D) cardiac catheterization

Questions about DCM

6) What is the diagnostic tool of choice
for diagnosinginfiltrativedisease that
may cause dilated cardiomyopathy?
A) Electrocardiogram
B) chest radiograph
C) cardiac MRI
D) cardiac catheterization