Dilated cardiomyopathy

Extract

• Asymptomatic incipient dilated cardiomyopathy (DCM) may first manifest as an enlarged heart shadow on a chest x-ray or an abnormal ECG finding.
• Typical symptoms in the early stages include dyspnoea on exertion, arrhythmias and sometimes a feeling of pressure or a long-lasting, mild pain in the chest that is not related to exercise. As the disease progresses, the patient will develop heart failure and associated oedema.
• If previously undiagnosed heart failure or left ventricular dilatation is noted, the cause must be determined.
• Pharmacological therapy is similar to that used in heart failure of any aetiology.
• DCM is in at least 30% of cases hereditary, i.e. running in families.
  • A negative family history does not exclude the possibility of hereditary disease. Gene testing of index patients is usually recommended.
  • If there is hereditary disease, appropriate monitoring should be arranged for the patient’s relatives.

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