Dilated Cardiomyopathy

General¶

• Dilated Ventricles with normal wall thickness, depressed myocardial contractility
  • Absence of hypertension or valvular disease
  • AA ~3x more likely to develop
• Left ventricular dysfunction causes progressive HF
  • Arrhythmias, conduction abnormalities, thromboembolism, SCD
  • Symptomatic HF + DCM: 50% 5-year mortality
• Diagnosis: Echocardiography
  • Eccentric LV hypertrophy
  • Dilated ventricles with diffuse hypokinesia, low EF, CHF

A) Idiopathic (MC)¶

• Viral Myocarditis (Infectious):
  • Coxsackie B
  • Chagas
  • HIV

B) Familial¶

C) Metabolic¶

• Thiamine Deficiency, Obesity, DM, hyperthyroidism

D) Alcoholic Cardiomyopathy (Toxic)¶

• CHF w/heavy alcohol consumption, macrocytic anemia, no CAD
  • History (>5-10) years of excessive (>7 drinks/day) of consumption
• Treatment: Alcohol abstinence

F) Hemochromatosis (Dilated > Restrictive): Can be reversed with phlebotomy¶

• Late hemochromatosis

G) Other¶

• Acromegaly, Cocaine
• Cancer chemo (doxorubicin, daunorubicin) - Anthracyclines
• Ephedra, Cobalt, Anabolic steroids, Chloroquine, Clozapine, Amphetamines, Methylphenidate, Catecholamines, Tachycardia, Organic Solvents (glue sniffer’s heart)