Characterised by dilatation and impaired systolic function of the left and/or right ventricle.
Rule out: abnormal loading conditions (hypertension, valve disease) and coronary disease. Must have NORMAL valves and coronaries to qualify.
- o Congestive heart failure and therefore symptoms are of left and/or right heart failure.
- o Syncope due to ventricular arrhythmia or conduction disease
- o Pulmonary or systemic embolism
- o Sudden death
- Chest xray
- Generalised cardiac (ventricular) enlargement (=dilation)
- Diffuse non-specific ST segment and T wave changes.
- Sinus tachycardia
- Conduction abnormalities
- Ventricular arrhythmias
- Dilation of left and/or right ventricle with poor global contraction function
- Performed to exclude coronary artery disease in all individuals at risk
Aetiology – cause, risk factors
Cause is unknown in the majority of cases = idiopathic
|Genetic||Autosomal dominant DCM|
Connective tissue disease (SLE, systemic sclerosis)
|Metabolic||Glycogen storage disease|
|Haematological||Sickle cell anaemia
Thrombotic thrombocytopenic purpura
Goals are to relieve symptoms, stop disease progression and prevent complications.
- o Relieve congestive symptoms
- o Do not use in isolation as exacerbate activation of neurohormones that may contribute to disease progression.
- ACE inhibitors, ARBS, spironolactone, beta-blockers
- o Stop progression of disease
- o Beta blockers also prevent arrhythmias
Cardiac transplant for advanced disease if medical therapy doesn’t work.