Dilated cardiomyopathy

Question 1

Dilated cardiomyopathy (DCM) basics:

Answer 1

• dilated heart leading to systolic (+/- diastolic) dysfunction
• all 4 chambers affected but LV more so than RV
• features include arrhythmias, emboli, mitral regurgitation
• absence of congenital, valvular or ischaemic heart disease

Question 2

What are the causes of dilated cardiomyopathy?

Answer 2

• alcohol: may improve with thiamine
• postpartum
• hypertension

Question 3

Other causes of Dilated cardiomyopathy (DCM)?

Answer 3

• inherited
• infections e.g. Coxsackie B, HIV, diphtheria, parasitic
• endocrine e.g. Hyperthyroidism
• infiltrative* e.g. Haemochromatosis, sarcoidosis
• neuromuscular e.g. Duchenne muscular dystrophy
• nutritional e.g. Kwashiorkor, pellagra, thiamine/selenium deficiency
• drugs e.g. Doxorubicin

Question 4

Inherited dilated cardiomyopathy?

Answer 4

• around a third of patients with DCM are thought to have a genetic predisposition
• a large number of heterogeneous defects have been identified
• the majority of defects are inherited in an autosomal dominant fashion although other patterns of inheritance are seen