II. Epidemiology
- Onset age 40-59 years old
-
Prevalence: 1 in 2500
- Leading cause of Heart Transplantation in the United States
III. Pathophysiology
- Familial (Autosomal Dominant) in 25-35% of cases
- Dilated Cardiomyopathy Definition
- Ventricular enlargement AND
- Normal left ventricular wall thickness AND
- Systolic Dysfunction
IV. Causes
- See Secondary Cardiomyopathy
- Genetic causes account for 30-40% of cases
- Other secondary causes include infectious, environmental exposures and systemic conditions
V. Findings
VI. Diagnostics
-
Electrocardiogram (EKG) Findings
- Septal Q Waves
- Bundle Branch Block
- Tachyarrhythmia
- Decreased QRS voltage
-
Echocardiogram
- First-line study in suspected Cardiomyopathy
-
Cardiac MRI Indications
- Tissue characterization to define undelying cause and extent including accurate LVEF estimate
- Risk stratification for complications
VII. Management
- See Systolic Dysfunction
- Specific treatments for underlying cause if identified
- Arrhythmia management
- Anticoagulation for Atrial Fibrillation
- Consider AICD
-
Exercise precautions
- Moderate intensity aerobic Exercise is safe and encouraged (improves Cardiac Function and quality of life)
- Caution with high intensity Exercise (modify in light of individual patient Exercise tolerance)