Dilated cardiomyopathy is a progressive disease of heart muscle that is characterized by ventricular chamber enlargement and contractile dysfunction. Dilated cardiomyopathy can be familial genetic, and it is estimated that 2030% of children with dcm have a relative with the disease, although they may not have been diagnosed or have symptoms. Although most cases are idiopathic, a number of conditions e. Dilated or congestive cardiomyopathy is the most frequent cardiomyopathy during fetal life. Pathophysiology of dilated cardiomyopathy full text view. Owing to the considerable aetiological and prognostic heterogeneity in dcm, an extensive diagnostic workup is recommended. Dilated cardiomyopathy symptoms and causes mayo clinic. To recognise the merits and disadvantages of each imaging modality used to assess viability. A rigorous workup can exclude alternative causes of left ventricular lv dilation and dysfunction, identify etiologies that may respond to specific treatments, and guide family screening. Historically, it was linked to a dietary deficiency in taurine, which has been corrected by most cat food manufacturers. From a pathologic standpoint, the term dilated cardiomyopathy is. Dilated cardiomyopathy cardiovascular disorders msd. Dilated cardiomyopathy can be genetic or acquired and typically presents with classic symptoms of heart failure with reduced ejection fraction.
Often, there are ventricular and supraventricular arrhythmias, conduction system abnormalities, and thromboembolism. A j marian jan 1, p 581 postulates that cardiac contractility is decreased in hypertrophic cardiomyopathy hcm and that the preserved or increased ejection fraction observed in patients with hcm is a result of the concentric nature of the hypertrophy. Dec 05, 20 pathophysiology of dilated cardiomyopathy the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. There are two pathophysiological theories that allow above normal conduction velocities and failure to capture the myocardium. Marin predicts that study of young patients with familial hcm will reveal decreased myocyte contractility and postulates that insulinlike. The most frequent causes are coronary artery disease, infectious myocarditis, deposition diseases such as hemochromatosis and amyloidosis, and medications, in particular chemotherapeutic agents or recreational drugs like. Shortness of breath when you exert yourself unexplained tiredness or weakness chest pain fluid buildup in the lungs. Dilated cardiomyopathy is the third most common cause of heart failure and the most frequent reason for heart transplantation. Dilated cardiomyopathy has many known and probably many unidentified causes see table causes of dilated cardiomyopathy. Dcm is characterized by a poorly contracting dilated left ventricle and oftentimes enlarged atria.
Sliwa k pathophysiology and epidemiology of peripartum. Restrictive cardiomyopathy is much less common and. This disease is rarely diagnosed in cats or smallbreed dogs. Dilated cardiomyopathy is characterised by left ventricular dilation and dysfunction in the absence of coronary disease, valvular disease or hypertension. Genetic mutations involving genes that encode cytoskeletal, sarcomere, and nuclear envelope proteins, among others, account for up to 35% of cases. A fourth category, arrhythmogenic right ventricular cardiomyopathy, now referred to as arrhythmogenic cardiomyopathy, was added more recently. Acquired causes include myocarditis and exposure to alcohol, drugs and toxins, and metabolic and endocrine disturbances. Prasad, md abstract dilated cardiomyopathy dcm is best understood as the. Listing a study does not mean it has been evaluated by the u. The diagnosis and evaluation of dilated cardiomyopathy.
Dilated cardiomyopathy dcm is a disease of the heart muscle which causes the heart to weaken and enlarge. More than 20 viruses can cause dilated cardiomyopathy. Dcm usually affects both the left and right sides of the heart. Pathophysiology of dilated cardiomyopathy the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Cardiomyopathy knowledge for medical students and physicians. She is an rcvs specialist in veterinary cardiology and currently works as a research fellow in veterinary cardiology at edinburgh. Pathophysiology, diagnosis and treatment of tachycardiomyopathy. Dilated cardiomyopathy dcm is a heterogeneous group of myocardial diseases clinically defined by the presence of left ventricular dilatation and contractile dysfunction.
The term cardiomyopathy is a general term that refers to the abnormality of the heart muscle itself. Coronary artery disease narrowing of the hearts blood vessels. Pathophysiology dilated cardiomyopathy ncbi bookshelf. Registered users can save articles, searches, and manage email alerts. The ventricle stretches and thins dilates and cant pump blood as well as a healthy heart can. These include increased hemodynamic overload, ventricular remodeling, excessive neurohumoral stimulation, abnormal myocyte calcium cycling, excessive or inadequate proliferation of the extracellular matrix, accelerated apoptosis, and genetic. Dilated cardiomyopathy, the most common type of the disease, is characterized by an enlarged heart with stretching of the ventricle lower chamber and atrium upper chamber. Learn for free about math, art, computer programming, economics, physics, chemistry, biology, medicine, finance, history, and more. The right ventricle may also be dilated and dysfunctional. Objective dilated cardiomyopathy dcm is characterised by left ventricular dilation and dysfunction not caused by coronary disease, valvular disease or hypertension. Dilated cardiomyopathy is the most common type of cardiomyopathy. Other types of cardiomyopathy causing a restrictive type of pathophysiology.
Results of comprehensive diagnostic workup in idiopathic. There may be great variability in the presentation of dilated cardiomyopathy in. A significant proportion of dcm cases have an underlying. The diagnosis and evaluation of dilated cardiomyopathy alan g. Signs and symptoms of dcm dilated cardiomyopathy can appear along a spectrum of no symptoms, subtle symptoms or, in the more severe cases. This wellcharacterized model of dilated cardiomyopathy possesses structural and functional similarities to human diseases.
Mar 11, 2000 a j marian jan 1, p 581 postulates that cardiac contractility is decreased in hypertrophic cardiomyopathy hcm and that the preserved or increased ejection fraction observed in patients with hcm is a result of the concentric nature of the hypertrophy. Dilated cardiomyopathy dcm is best understood as the final common response of myocardium to diverse genetic and environmental insults. Rcm may be associated with symptoms and signs of congestive heart failure, such as peripheral oedema, raised jugular venous pressure and gallop rhythm, as well as features of an underlying systemic disease. Several pathogenetic mechanisms appear to be operative. Understanding the progression of dilated cardiomyopathy will be critical in the design of treatment modalities to intervene at the molecular level in the initial stages of pathogenesis.
Dilated cardiomyopathy american stroke association. Typically, both the ventricles and the atria are enlarged and often the muscular walls of the heart are much thinner than normal. Dilated cardiomyopathy is characterised by ventricular chamber enlargement and. Study 53 terms pathophysiology cardiomyopathy flashcards. Fluid retention resulting in swollen feet or ankles or unexplained weight gain. Pathophysiology of hypertrophic cardiomyopathy the lancet.
Frequently the disease starts in the left ventricle, the hearts main pumping chamber. Patients with dilated cardiomyopathy may experience a progressive decline in left ventricular contractile function, ventricular and supraventricular arrhythmias, conduction system problems, thromboembolism, sudden cardiac death andor heart failure. Dilated cardiomyopathy is a disease of the heart muscle, usually starting in your hearts main pumping chamber left ventricle. A diagnosis of dilated cardiomyopathy requires evidence of dilation and impaired contraction of the left ventricle or both ventricles eg, left ventricular ejection fraction of heart disease eg, myocarditis and. Pathophysiology and treatment of hypertrophic cardiomyopathy mark v. Dilated cardiomyopathy dcm american heart association. With restrictive cardiomyopathy, the heart muscle becomes hard and stiff. In central and south america, chagas disease due to trypanosoma cruzi is the most common infectious cause. Dilated cardiomyopathy is the most common cause of heart failure up to 36% of cases of dilated cardiomyopathy can be due to alcohol misuse several types of cardiomyopathy are associated with sudden cardiac death stressinduced cardiomyopathy is often preceded by intense emotional or physical stress many cardiomyopathies are rare diseases. In many cases of cardiomyopathy, an exact cause is never known. Jun 17, 2019 other types of cardiomyopathy causing a restrictive type of pathophysiology. Pathophysiology of narrow complex dilated cardiomyopathy. Dilated cardiomyopathy dcm is the most common type, occurring mostly in adults 20 to 60.
The left ventricle, which pumps oxygenated blood to the body tissues, shows weakness in contraction systolic dysfunction and stiffness in expansion and filling. Dilated cardiomyopathy dcm, a leading cause of heart failure and heart transplantation in. The resulting damage to the heart muscle is often known as ischemic cardiomyopathy. Dilated cardiomyopathy is characterized by decreased. To understand the pathophysiology of ischaemic cardiomyopathy and define the terms viability, stunning and hibernation. Nov 04, 2015 dilated cardiomyopathy is a progressive, usually irreversible, disease causing global systolic contractile dysfunction with heart failure. An attempt should be made to detect the presence or absence of risk factors for sudden arrhythmic death. These include increased hemodynamic overload, ventricular remodeling, excessive neurohumoral stimulation, abnormal myocyte calcium cycling, excessive or inadequate proliferation of the extracellular matrix, accelerated apoptosis, and genetic mutations. Dcm is the most prevalent form of cardiomyopathy with an incidence of one in approximately 2500 individuals. Dilated cardiomyopathy is a progressive, usually irreversible, disease causing global systolic contractile dysfunction with heart failure.
A diagnosis of dilated cardiomyopathy requires evidence of dilation and impaired contraction of the left ventricle or both ventricles eg, left ventricular ejection fraction sheet. With hypertrophic cardiomyopathy, the heart muscle thickens. Dilated cardiomyopathy is defined by the presence of left ventricular dilatation and contractile dysfunction. You may need extra pillows to help you breathe when you lie down. The hallmark pathophysiologic feature of dilated cardiomyopathy is systolic dysfunction. Pathophysiology dilated cardiomyopathy pdf dilated cardiomyopathy is considered as the most common cause of chronic. The diagnosis and evaluation of dilated cardiomyopathy jacc. By utilising the velocity equation, the pathophysiology of narrow complex cardiomyopathy allows above normal conduction propagation velocities. Furazolidoneinduced cardiomyopathy is an inexpensive model of dilated congestive cardiomyopathy which rapidly produces a high yield of uniformly affected individuals. Sherrid all patients with hypertrophic cardiomyopathy hcm should have five aspects of care addressed. Etiology and panduan ramadhan pdf pathogenesis of dilated cardiomyopathy. The most common cause of heart failure weintraub et al, 2017, dcm is diagnosed on the basis that it cannot be explained by either abnormal loading conditions increased blood pressure or volume or coronary artery disease, where an ischaemic cardiomyopathy may occur elliott et al, 2008. Dilated or congestive cardiomyopathy dcm is diagnosed when the heart is enlarged dilated and the pumping chambers contract poorly usually left side worse than right.
Pathophysiology and treatment of hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy echocardiogram screening and diagnosis cardinal sign is lv hypertrophy of septum and anterolateral free wall variability in hypertrophy dilated left atrium normal to nearnormal ef septum at least 1. Review topic of the week the diagnosis and evaluation of dilated cardiomyopathy alan g. A diagram and echocardiogram comparing a normal heart and a heart with dcm are shown in figure 1a and figure 1b. We aimed to assess the value of diagnostic testing beyond careful physical examination, blood tests. Overview dilated cardiomyopathy dcm is one of the most common acquired heart diseases in dogs.
A group of heart disorders, major structural abnormality is limited to the myocardium often result heart failure etiology frequently unknown hyperthrophic dilated cm restrictive cm cm. Dilated cardiomyopathy dcm, also known as congestive systolic cardiomyopathy, is recognized by impaired systolic function and global dilatation of either one or both ventricular chambers. The heart muscle begins to dilate, meaning it stretches and. There are two pathophysiological theories that allow above normal conduction velocities and failure to capture the. She has an mvm in veterinary neurology and a phd for studies on canine dilated cardiomyopathy. The pathophysiology of narrow complex dilated cardiomyopathy is not defined, so therapeutic options are limited. It affects the hearts ventricles and atria, the lower and upper chambers of the heart, respectively. Types of cardiomyopathy with dilated cardiomyopathy, the heart thins and enlarges. Secondly, most patients with dilated cardiomyopathy present with symptoms of heart failure, and as stated above, recommendations for treatment in heart failure do not take into account individual differences in aetiology or pathophysiology.
Dilated cardiomyopathy is the third most common cause of heart failure. Dilated cardiomyopathy can be caused by a variety of disorders. Khan academy is a nonprofit with the mission of providing a free, worldclass education for anyone, anywhere. Dilated cardiomyopathy dcm dilated cardiomyopathy is rarely seen in cats today. Dilated cardiomyopathy dilated cardiomyopathy dcm, also known as congestive systolic cardiomyopathy, is recognized by impaired systolic function and global dilatation of either one or both ventricular chambers fig.
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