Cardiomyopathy is a heart disease in which the heart muscle becomes weakened, stretched or has another structural problem. It often occurs when the heart cannot pump or function well.
Dilated cardiomyopathy (DCM) is a cardiac condition where the heart muscle becomes weakened because its main pumping chamber, the left ventricle, is enlarged and dilated. The heart’s other chambers compensate by stretching and increasing the heart’s capacity to pump blood, but they cannot sustain the heart’s imbalance long-term.
As a result, kidneys often retain water and sodium, and if fluid builds up in the legs, ankles, feet, lungs or other organs, the body becomes “congested” (a condition known as congestive heart failure). Other symptoms of cardiomyopathy may include lightheadedness, chest tightness, shortness of breathing and fainting.
Because the precise cause or causes of dilated cardiomyopathy can vary from blocked arteries, viruses, toxic chemicals, genetics or pregnancy, the condition is also called an “idiopathic” cardiomyopathy.
Detection and diagnosis of dilated cardiomyopathy may include:
- Physical exam and blood tests
- Electrocardiogram (EKG)
- Chest x-ray
- Exercise stress test (also known as treadmill test)
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Radionuclide studies
- Cardiac catheterization (coronary angiogram)
Are you at risk of developing a dilated cardiomyopathy?
If you have a family member with idiopathic dilated cardiomyopathy, talk with your physician about getting screened and tested for the condition.
Treatment of dilated cardiomyopathy
Dilated cardiomyopathy is best treated with a multidisciplinary team of physicians, including heart failure physicians, interventional cardiologists and electrophysiologists who specialize in heart muscle function and heart electrical function. Treatment options include:
- Heart medications to help the heart regain strength, while reducing symptoms of cardiomyopathy.
- Implantable cardioverter defibrillator (ICD) to keep the heart beating at a healthy rate. The ICD is implanted under the skin and delivers silent pacing treatment or a shock to stop abnormal heart rhythms.
- Cardiac resynchronization therapy (CRT) to increase the heart’s pumping efficiency.
Scripps heart physicians are international leaders in the development of ICD and CRT therapy.
Hypertrophic cardiomyopathy is a genetic condition in which the heart muscle is thick and scarred. It often results in an inability to pump blood efficiently, especially during exercise. The result can be dizziness and fainting.
Because of the scarring in the heart muscle, some patients may develop a dangerous cardiac arrhythmia known as ventricular tachycardia. Besides dizziness and possible fainting, other symptoms of hypertrophic cardiomyopathy may include chest tightness, shortness of breath and a sensation that the heart is racing. Hypertrophic cardiomyopathy can also result in sudden cardiac death.
Detection and diagnosis of hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy is detected and diagnosed by a non-invasive test called an echocardiogram where an ultrasound machine records pictures of the heart’s structure and motion. The test may be performed before and after the patient exercises on a treadmill to see how the heart responds to physical effort.
Patients may be asked to wear a heart monitor (also known as mobile telemetry or event monitor) that continuously records the heart’s electrical activity. If you have symptoms or the device detects an abnormal heart rhythm such as a dangerous ventricular tachycardia, your doctor will be notified and he or she can review the heart monitor’s recordings to get a diagnosis.
Patients may also be asked to provide a blood sample so genes can be screened for inherited abnormalities.
Hypertrophic cardiomyopathy treatment may include:
- Antiarrhythmic medications that suppress the abnormal rhythm.
- Implantable cardioverter defibrillator (ICD) to keep the heart beating at a healthy rate. The ICD is implanted under the skin and delivers a shock to stop abnormal heart rhythms.
- Restrictive cardiomyopathy
- Ischemic cardiomyopathy
- Peripartum cardiomyopathy