Dilated Cardiomyopathy (DCM)

 

Dilated Cardiomyopathy (DCM)

Introduction:

The disorder known as dilated cardiomyopathy (DCM), which can be fatal, impairs the heart's ability to pump blood effectively. It is characterised by the left ventricle of the heart enlarging and weakening, which lowers its ability to pump blood. This article will discuss the definition, causes, kinds, stages, symptoms, diagnostic standards, tests, and available treatments for dilated cardiomyopathy.

Definition:

Dilated Cardiomyopathy is a form of heart muscle disease where the chambers of the heart become enlarged and weakened, resulting in poor blood circulation throughout the body. As the heart muscle stretches and becomes thinner, it becomes less efficient in pumping blood, leading to symptoms and potential complications.

Causes:

Many times, the precise cause of dilated cardiomyopathy is unknown. The growth of it, however, can be influenced by a number of circumstances and situations, like as:

1. Genetic factors: Certain gene mutations that are passed down via families can cause hereditary Dilated Cardiomyopathy.
2. Viral infections: Dilated Cardiomyopathy can be brought on by some viral infections, like myocarditis (heart muscle inflammation).
3. Alcohol and substance abuse: Dilated Cardiomyopathy can be brought on by some viral infections, like myocarditis (heart muscle inflammation).
4. Certain medications: Dilated Cardiomyopathy may result from the long-term use of various medications, including some antipsychotics and chemotherapeutic treatments.
5. Autoimmune diseases: Dilated cardiomyopathy can be brought on by illnesses including lupus, sarcoidosis, or rheumatoid arthritis.
6. Nutritional deficiencies: Dilated Cardiomyopathy can result from inadequate intake of vital nutrients like thiamine (vitamin B1).

Types of Dilated Cardiomyopathy:

Based on its source or accompanying disorders, dilated cardiomyopathy can be divided into several types, including:

1. Idiopathic Dilated Cardiomyopathy: A considerable portion of cases have an unknown source.
2. Ischemic Dilated Cardiomyopathy: Due to coronary artery disease, where there is a decreased blood flow to the heart muscle, it happens.
3. Inflammatory Dilated Cardiomyopathy: This kind is connected to myocarditis or other inflammatory cardiac disorders.
4. Genetic Dilated Cardiomyopathy: Specific gene mutations inherited from the parents are the cause.
5. Alcoholic Dilated Cardiomyopathy: Alcoholism destroys the heart muscle over time, causing dilated cardiomyopathy.
6. Peripartum Dilated Cardiomyopathy: It happens towards the end of pregnancy or soon after delivery, and it frequently resolves on its own over time.

Stages Dilated Cardiomyopathy

Dilated Cardiomyopathy can progress through four stages:

Stage 1: There are no symptoms or physical activity restrictions.

Stage 2: Mild symptoms and minimal restrictions when engaging in physical activity.

Stage 3: Observable signs and mild restrictions when exercising.

Stage 4: Significant limits, severe symptoms even when at rest, and a low quality of life.

Signs and Symptoms of Dilated Cardiomyopathy

• Common signs and symptoms of Dilated Cardiomyopathy include:
• Fatigue and weakness
• Shortness of breath, especially during exertion or lying flat
• Swelling (edema) in the legs, ankles, feet, or abdomen
• Rapid or irregular heartbeat
• Chest pain or discomfort
• Dizziness or lightheadedness
• Fainting or loss of consciousness (in advanced stages)

Diagnostic Criteria and Investigations:

The following diagnostic techniques and tests are frequently used to determine whether someone has dilated cardiomyopathy:

• Physical examination: evaluating the symptoms, hearing the heartbeat, and examining the fluid retention.
• Echocardiogram: Using ultrasound to assess the size, shape, and pumping efficiency of the heart.
• Electrocardiogram (ECG): The heart's electrical activity is recorded, and any anomalies are found.
• Cardiac MRI: gives clear photos of the heart so that you may evaluate its composition and operation.
• Blood tests: biomarker research, including specialised genetic testing, if a hereditary cause is thought to be involved.
• Coronary angiography: checking the heart's blood arteries to rule out coronary artery disease.

Treatment Options:

The goal of the Dilated Cardiomyopathy treatment programme is to control symptoms, limit the disease's course, and avert consequences. The therapy strategy can involve:

1. Medications: Drugs prescribed for treating symptoms, regulating blood pressure, reducing fluid retention, and enhancing heart function.
2. Lifestyle modifications: Establishing a heart-healthy lifestyle that consists of a balanced diet, frequent exercise, maintaining a healthy weight, and abstaining from alcohol and other drugs.
3. Implantable devices: Pacemakers or implantable cardioverter-defibrillators (ICDs) may be suggested in specific circumstances to control heart rhythm and prevent unexpected cardiac arrest.
4. Surgical interventions: Heart transplantation may be an option in severe situations or if medications and devices are unable to improve heart function.
5. Cardiac rehabilitation: a planned programme to enhance general heart health and quality of life that includes supervised exercise, education, and counselling.

Preventions of Dilated Cardiomyopathy (DCM)

Adopting a healthy lifestyle and treating underlying diseases that may lead to the development of Dilated Cardiomyopathy (DCM) are two ways to prevent it. While Dilated Cardiomyopathy (DCM) may not always be preventable, the following steps can significantly lower the risk:

1. Regular exercise: Maintain a healthy weight, enhance cardiovascular fitness, and advance general heart health by engaging in regular physical activity. Find out from a healthcare professional what kind and at what intensity of exercise is best for you.
2. Heart-healthy diet: Maintain a nutritious diet that is balanced and full of fruits, vegetables, whole grains, lean meats, and good fats. Reduce your consumption of processed meals, sweet drinks, and saturated and trans fats. If you have high blood pressure or fluid retention, think about a low-sodium diet.
3. Avoid alcohol and substance abuse: A type of Dilated Cardiomyopathy (DCM) called alcoholic cardiomyopathy can result from excessive alcohol use. Limit your alcohol consumption or don't drink at all. Stay away from illegal drugs as well, especially those that have negative effects on the heart.
4. Manage chronic conditions: Manage underlying medical disorders such diabetes, high blood pressure, and autoimmune diseases that may be a factor in Dilated Cardiomyopathy (DCM). Take prescription drugs as instructed, adhere to the recommended course of therapy, and visit your healthcare practitioner on a regular basis.
5. Genetic counseling and testing: Consider genetic counselling and testing if you have a family history of Dilated Cardiomyopathy (DCM) or believe there may be a genetic component. Making educated choices regarding family planning and early intervention can be facilitated by being aware of your genetic risk.
6. Seek prompt medical attention: Seek immediate medical assistance if you have any heart-related symptoms, such as palpitations, shortness of breath, or chest pain. Early diagnosis and prompt treatment of cardiac problems can stop or slow the development of Dilated Cardiomyopathy (DCM).
7. Manage stress: Chronic Heart health can be significantly impacted by stress. Adopt stress-reduction strategies including exercise, yoga, meditation, or hobby-based stress reduction to lower stress levels and enhance general wellbeing.
8. Follow prescribed medications: Follow your doctor's prescription recommendations carefully if you have a heart ailment or other risk factors for it. These drugs could ease your symptoms, regulate your blood pressure, or lessen the strain on your heart.

It's crucial to remember that while these precautions can lower the likelihood of getting Dilated Cardiomyopathy (DCM), they cannot completely ensure prevention. Idiopathic or unidentified reasons may be present in some Dilated Cardiomyopathy (DCM) cases. To successfully monitor your heart health and treat any underlying issues, regular checkups and open contact with your doctor are crucial.

Conclusion:

A complex cardiac ailment called dilated cardiomyopathy causes the heart muscle to expand and weaken, which reduces its ability to pump blood and may cause difficulties. For people with Dilated Cardiomyopathy (DCM), prompt diagnosis, effective treatment, and lifestyle changes can greatly improve outcomes and quality of life. It is imperative to get medical advice from a specialist if you have any symptoms or worries about your heart health in order to receive an accurate assessment and recommendations.

 

Dr.Muhammad Arsalan Khan
MBBS, DHHM, MSc (D & E)
CCD-BMJ-AKU-RCP (London)