Dilated Cardiomyopathy

Most common form of cardiomyopathy, characterised by ventricular chamber enlargement and contractile dysfunction with normal left ventricular wall thickness

Aetiology

  • Familial DCM is associated with mutations in genes responsible for cytoskeleton or proteins involved in contractions; it is predominantly autosomal dominant
  • Sporadic DCM can be caused by multiple conditions:
    • Toxins e.g. drugs, alcohol, chemotherapy (doxorubicin)
    • Myocarditis
    • Autoimmune disorders
    • Endocrine disorders
    • Neuromuscular disorders

Pathophysiology

  • DCM is characterized by enlarged ventricular size, with normal ventricular wall thickness and systolic dysfunction
  • Heart becomes ‘floppy’ with reduced ejection fraction

Clinical presentation

  • Heart failure - dyspnoea, pulmonary oedema etc.
  • Cardiac arrhythmias
  • Conduction defects
  • Thromboembolism
  • Sudden death

Investigations

  • ECG - ST-segment and T wave changes
  • Echocardiogram - dilation of left and/or right ventricle with poor contraction function
  • Cardiac MRI

Management

  • Manage heart failure
  • Consider ICD