Dilated cardiomyopathy

Question 1

General description:

Answer 1

Chambers of the heart becomes enlarged, myocardium thins, heart has a lower strength of contraction, therefore a lower stroke volume

Question 2

Aetiology/Risk Factors:

Answer 2

Aetiology:

• Idiopathic
• Ischaemia
• Valvular heart disease
• Genetic/congenital (X-linked)
• Alcoholism
• Thyrotoxicosis
• Haemochromatosis
• Autoimmune

Question 3

Symptoms:

Answer 3

• Progressive, slow onset
• Dyspnoea (at rest)
• Orthopnea
• Fatigue
• Oedema (pulmonary and ankle)
• Cough

Question 4

Signs:

Answer 4

• Tachycardia
• Hepatomegaly
• Raised JVP
• Audible S3 (gallop)
• Weak pulse
• Jaundice
• Ascites
• Pleural effusion

Question 5

Investigations:

Answer 5

• ECG (noting an left bundle branch block)
• Chest x-ray (cardiomegaly, pulmonary oedema)
• N terminal pro B - natriuretic peptide blood test
• Basic blood tests (FBC, U+E)
• Echocardiography
• Cardiac MRI
• Coronary angiogram

Question 6

Treatment:

Answer 6

• Diuretics (thiazide)
• ACE inhibitors
• Spironlactone
• Beta blockers
• Digoxin
• Warfarin
• Heart transplant

Question 7

Dilated cardiomyopathy has a good/poor prognosis.

Answer 7

Poor