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Dilated Cardiomyopathy

What is dilated cardiomyopathy?

Dilated cardiomyopathy (DCM) is a disease of your heart muscle that causes the ventricles to become larger and weaker. The ventricles are the 2 lower chambers of your heart. They pump blood to your lungs and the rest of your body. When the ventricles are dilated and weak, your heart cannot pump blood well. This decreases the blood and oxygen supply to the rest of your body.


What causes dilated cardiomyopathy?

Sometimes the cause of DCM is not known. Many illnesses and health problems may cause DCM. Following are possible causes of DCM:

  • Genetic or birth defects, such as valve defects

  • Viral infections

  • Heart disease, such as coronary artery disease

  • Nutritional problems

  • Certain chemotherapy medicine

  • Drug and alcohol abuse

What are the signs and symptoms of dilated cardiomyopathy?

You may not have any signs or symptoms. The following signs and symptoms may start slowly:

  • Chest pain or trouble breathing

  • Feeling like your heart is beating fast, fluttering, or jumping in your chest

  • Swollen or bulging neck veins

  • Fatigue, dizziness, or fainting

  • Hands and feet that are pale or feel cold to the touch

  • Swollen feet and ankles

How is dilated cardiomyopathy diagnosed?

Your caregiver will listen to your heart and lungs. He may check your abdomen, ankles, and feet for swelling. Tell him if you have other health conditions or family members with heart disease. Tell your caregiver if you smoke, drink alcohol, or take drugs. You may need the following tests:

  • Blood tests: A sample of your blood may be sent to the lab for tests. The tests may help find the cause of your DCM. They may also tell if your organs, such as your liver and kidneys, are working correctly.

  • EKG: This test records the electrical activity of your heart. It may show abnormal heartbeats or signals from changes to the heart muscle.

  • Chest x-ray: This is used to check the size of your heart and look for fluid around your heart and lungs.

  • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart.

  • Radionuclide ventriculography: This test uses dye to show the size of your left ventricle. It can also show how much blood is pumped out of the heart with each heartbeat.

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your heart. Caregivers can check your heart, the size of your ventricles, and see if you have fluid around your heart and lungs. You may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

  • Cardiac MRI (CMR): This scan uses powerful magnets and a computer to take pictures of your heart. A CMR may show the size of your heart and the thickness of your ventricles. It can also show if you have iron buildup in your heart. You may be given dye to help the pictures show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the CMR room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.

  • Cardiac catheterization: This is a procedure done to find the cause of and treat a heart condition. A thin, bendable tube inserted into an arm, neck, or groin vein is moved into your heart. Your caregiver may use an x-ray to guide the tube to the right place. Dye (contrast) may be put into your vein so the pictures show up better on a monitor.

  • Tissue biopsy: During this test, a small sample of tissue is taken from your heart to help find the cause of DCM. It can also be used to check for damage caused by DCM.

What medicines are used to treat dilated cardiomyopathy?

  • Diuretics: This medicine helps decrease fluid around your lungs and heart. It also helps decrease extra fluid in your legs and ankles. You will urinate more often when you take diuretics.

  • Blood thinners: Blood thinners help prevent blood clots. These include aspirin and warfarin. Take your medicine exactly as directed. Tell your caregiver if you forgot to take it or if you took too much. Blood thinners may cause you to bleed or bruise more easily. Use a soft toothbrush and an electric shaver. Wear medical alert jewelry or carry a card that says you take a blood thinner. Tell all caregivers, including your dentist, that you take this medicine.

  • Blood pressure medicine: This is given to lower your blood pressure. A controlled blood pressure helps protect your organs, such as your heart, lungs, brain, and kidneys. Take your blood pressure medicine exactly as directed.

  • Heart medicine: This medicine helps strengthen or regulate your heartbeat.

What treatments are used to treat dilated cardiomyopathy?

  • Pacemaker: This device is placed under your skin to help regulate your heartbeats.

  • Implantable cardiac defibrillator: A cardiac defibrillator is placed under your skin to help prevent life-threatening arrhythmias (abnormal heartbeats).

  • Left ventricle assist device (LVAD): This device is placed under your skin to help your heart pump better. You may need an LVAD while you are waiting for a heart transplant.

  • Heart valve surgery: You may need to have a heart valve repaired or replaced so your heart can pump enough blood to your body. Heart valves allow blood flow between the chambers of your heart.

  • Heart transplant: During a heart transplant, your diseased heart is removed and replaced with a donor heart.

What are the risks of dilated cardiomyopathy?

You may bleed more than expected or get an infection after surgery. Without treatment your heart may get weaker and your symptoms may get worse. You may have abnormal heartbeats, trouble breathing, or get a blood clot. The clot may travel to your heart or brain and cause a heart attack or stroke. Fluid may build up in your lungs and body. This may make it hard for you to breathe. Your liver and kidneys may fail. These problems can be life-threatening.

How can I manage my symptoms?

  • Check your weight daily: Weight gain can be a sign of extra fluid in your body. Weigh yourself at the same time every morning. Use the same scale and weigh yourself before you eat and after you urinate. Record your weight and the time you weighed yourself in a diary. Bring your diary to your visits with your caregiver.

  • Limit your liquids: Ask how much liquid to drink each day and which liquids are best for you. Your risk for fluid buildup and swelling increases if you drink too much liquid.

  • Manage your health conditions: Health conditions, such as diabetes and high blood pressure, may make your symptoms worse and increase your risk for other heart problems.

  • Exercise: Ask your caregiver about the best exercise plan for you. Exercise may help decrease your symptoms and improve your heart function.

  • Wear support socks: These socks may help decrease the swelling in your legs until you can walk more. They may also keep blood from staying in your legs and causing clots.

  • Eat a variety of healthy foods: Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Limit the amount of sodium (salt) you eat. Too much sodium can cause swelling and make your symptoms worse. Ask how much sodium you can have each day. Pay careful attention to sodium content on food labels.

  • Do not drink alcohol, smoke, or use drugs: If you smoke it is never too late to quit. Do not take any illegal street drugs. Alcohol, smoking, or illegal drugs can make your heart condition worse. Ask for information if you need help quitting.

When should I contact my caregiver?

Contact your caregiver if:

  • You gain weight for no known reason.

  • You feel weak or more tired than usual.

  • You have increased swelling in your legs, ankles, feet, or abdomen.

  • Your symptoms return or get worse.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You feel like your heart is beating faster than normal, fluttering, or jumping in your chest.

  • You urinate less than usual or not at all.

  • You have chest pain that may be worse when you take a deep breath or cough. You may cough up blood.

  • You have a sudden cold sweat, especially with chest discomfort or trouble breathing.

  • You feel very lightheaded or dizzy, especially with chest discomfort or trouble breathing.

  • You have pain or discomfort in your back, neck, jaw, abdomen, or one or both of your arms.

  • You have a severe headache or vision loss.

  • You have weakness in an arm or leg.

  • You are confused or have difficulty speaking.

  • You suddenly have trouble breathing.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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