Topic Overview
What is dilated cardiomyopathy?
Dilated cardiomyopathy is a serious condition that weakens your heart muscle and
causes it to stretch, or dilate. When your heart muscle is weak, it can't pump
out blood as well as it should, so more blood stays in your heart after each
heartbeat. As more blood fills and stays in the heart, the heart muscle
stretches even more and gets even weaker.
If your heart gets weaker, you may develop heart failure. Heart failure does not mean that your
heart stops pumping. It means that your heart can't pump enough blood to meet
your body's needs.
What causes dilated cardiomyopathy?
The most
common type of dilated cardiomyopathy develops after a heart attack has damaged
the heart muscle. But it can also be caused by many diseases or problems that
may or may not be related to your heart. Sometimes the cause is not known.
Some of the things that can lead to dilated cardiomyopathy
include:
- Coronary artery disease and
heart attack.
- High blood pressure, which can put stress on the heart walls.
- Heart
valve diseases, including
aortic valve regurgitation and
mitral valve regurgitation.
- Heartbeat problems (arrhythmias).
- Myocarditis,
which is inflammation of the heart muscle. It is caused by a virus or an immune
system problem.
- Drinking too much alcohol, using certain illegal drugs such as
cocaine, or taking certain medicines such as
chemotherapy.
- Being exposed to toxic
metals, such as lead or mercury.
- Being pregnant. In rare cases,
dilated cardiomyopathy develops toward the end of pregnancy or during the first
6 months after a woman gives birth. Experts don't know why this happens.
- Having a family history of dilated cardiomyopathy.
What are the symptoms?
You may not have any
symptoms at first. Or you may have mild symptoms, such as feeling very tired or
weak.
If your heart gets weaker, you may develop heart failure.
If this happens, you will feel other symptoms, including:
- Shortness of breath, especially with
activity.
- Tiredness.
- Trouble breathing when you lie
down.
- Swelling in your legs.
You may get these symptoms slowly, over months or years.
Or you may get them suddenly, such as after pregnancy or an illness caused by a
virus.
Heart failure that suddenly gets worse is an emergency. Get
medical help right away if:
- You have severe trouble breathing.
- You cough up pink, foamy mucus.
- You have a new irregular or rapid heartbeat.
Keeping track of your symptoms every
day is important. Call your doctor if:
- You have a sudden weight gain, such as more than 2 lb (0.9 kg) to 3 lb (1.4 kg) in a day or 5 lb (2.3 kg) in a week. (Your doctor may suggest a different range of weight gain.)
- Your ability to exercise changes.
- You have
any change in your symptoms.
How is dilated cardiomyopathy diagnosed?
Your
doctor will ask questions about your symptoms and past health. He or she will
want to know about recent illnesses and about heart disease in your family.
Your doctor will listen to your heart and lungs and check your legs for fluid
buildup.
You may also have other tests, including:
In some cases, a doctor may want to look at a small
sample of heart tissue, called a biopsy, to make a definite diagnosis.
How is it treated?
Treatment for dilated cardiomyopathy focuses on relieving your symptoms, improving heart function, and helping you live longer. You may also have treatment for the cause of the cardiomyopathy.
You will probably need to take several medicines. It is very important to take your medicines exactly as your doctor tells you to and to keep taking them. If you don't, your heart function could get worse.
Your doctor may suggest a mechanical device to help your
heart pump blood or to prevent life-threatening irregular heart rhythms. Such
devices include a
pacemaker for heart failure (also called cardiac resynchronization therapy or CRT), an
implantable cardioverter-defibrillator (ICD), or a
combination pacemaker and ICD. If your condition is very bad, a heart
transplant may be an option.
Self-care is an important part of your treatment. Self-care includes the things you can do every day to feel better, stay healthy, and avoid the hospital.
- Take your medicines as prescribed. This gives you the best chance of being helped by them. Some medicines include:
- Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs). These make it easier for blood to flow.
- Diuretics. These help remove excess fluid from the body.
- Beta-blockers. These slow the heart rate and can help the heart fill with blood more completely.
- Live a healthy lifestyle. Limit salt, try to get regular exercise, and don't smoke.
- Watch for signs you're getting worse. Weighing yourself every day to watch for sudden weight gain is a good way to do this.
What can you expect with dilated cardiomyopathy?
If your heart gets weaker, you may develop heart failure. If the cause of
dilated cardiomyopathy can be treated, this can slow or stop the progression of the
disease. For some types of cardiomyopathy, treatment can help the heart work better.
Some people
develop other problems, including:
- Stroke.
- Heart attack.
- Sudden cardiac death, which means the heart suddenly stops
working. This may be more likely to happen to people who have serious rhythm
problems (arrhythmias) in one of the lower heart chambers (ventricles).
If a woman gets dilated cardiomyopathy from pregnancy,
she should not get pregnant again. This is true even if her heart problem gets better.
If your disease is getting worse, you may
want to think about making end-of-life decisions. It can be comforting to know
that you will get the type of care you want.