Dilated Cardiomyopathy

What is dilated cardiomyopathy?

Dilated cardiomyopathy occurs when your heart’s main pumping chamber (left ventricle) becomes enlarged. In severe cases, it affects additional areas of your heart.

How can dilated cardiomyopathy affect my well-being?

When your left ventricle becomes enlarged, tissue thins, causing it to pump with less force. After each beat, more blood remains in your heart. This makes it increasingly difficult to keep up with your body’s needs. In advanced stages, dilated cardiomyopathy can lead to heart failure and other complications.

What other complications are associated with dilated cardiomyopathy?

Additional complications may include:

• Abnormal heart rhythms (arrhythmia).
• Angina (chest pain).
• Blood clots in your heart.
• Heart attack.
• Heart valve disease.
• Stroke.
• Sudden cardiac arrest.

What causes dilated cardiomyopathy?

In many cases, the cause is unknown. Sometimes, the condition runs in families (familial dilated cardiomyopathy).

When healthcare providers can pinpoint a cause, it may be:

• Alcohol-use disorder.
• Certain chemotherapy drugs that are toxic to your heart (cardiotoxic).
• Complications in the late stages of pregnancy or shortly after childbirth.
• Congenital heart disease.
• Diabetes.
• Heart attack.
• Heart valve disease.
• Infection, such as myocarditis.
• Recreational drugs, like cocaine.
• Thyroid disease.
• Unmanaged high blood pressure.
• Viral hepatitis.
• Viral myocarditis.
• HIV.

What are dilated cardiomyopathy symptoms?

Many people with dilated cardiomyopathy have no symptoms, especially in the early stages. As heart function worsens, symptoms become more noticeable. The first symptom is often a heart murmur.

Additional dilated cardiomyopathy symptoms may include:

• Cough and congestion.
• Dizziness or lightheadedness.
• Fainting.
• Fatigue, unusual tiredness.
• Palpitations or fluttering in your chest.
• Shortness of breath (dyspnea).
• Swelling in your legs and feet (edema).
• Unexpected weight gain due to fluid retention.

How is dilated cardiomyopathy diagnosed?

Your healthcare provider begins by taking your medical history and performing a physical exam. This may include listening to your lungs to check for fluid build-up.

Testing determines the severity and assists healthcare providers with dilated cardiomyopathy treatment planning. You may need:

• Angiography.
• Blood tests.
• Chest X-ray.
• Echocardiogram.
• Electrocardiogram (EKG).
• Exercise stress test.
• Genetic testing to determine whether cardiomyopathy was inherited.
• Myocardial biopsy.

How is dilated cardiomyopathy treated?

A variety of dilated cardiomyopathy treatments may be necessary. Your care may start with medications that improve heart function. These include:

• Beta-blockers.
• ACE inhibitors.
• Aldosterone receptor blockers (ARB).
• Angiotensin receptor-neprilysin inhibitors (ARNi).
• Diuretics.
• Anti-arrhythmics, drugs that treat abnormal heart rhythms.
• Blood thinners (anticoagulants).

Are there additional nonsurgical therapies that can help me?

Lifestyle changes can help improve the effectiveness of medications and possibly help you delay or avoid a procedure.

These changes include:

• Addressing unhealthy habits: You may be able to drink alcohol in limited quantities. If you use recreational drugs, quitting can help your heart. People who have unprotected sex with multiple partners should use condoms to lower their risk of viral hepatitis and HIV.
• Eating a heart-healthy diet: Consume lean proteins, like chicken and fish, and plenty of fruits and vegetables. Following a low-sodium diet can prevent fluid build-up that puts extra strain on your heart.
• Increasing physical activity: Gentle exercises can improve heart function. A cardiac rehabilitation program provides a safe environment for getting started.

What procedures treat dilated cardiomyopathy?

If you have advanced dilated cardiomyopathy, your heart function may be severely compromised. A procedure may be necessary to improve it. These include:

Implantable devices

These devices can help your heart pump harder or more regularly. Options include:

• Biventricular pacemaker.
• Implantable cardioverter defibrillator (ICD).

Other surgical procedures

Additional procedures include:

• Heart failure surgery to improve your heart function.
• Heart transplant.

What can I do to prevent dilated cardiomyopathy?

It’s not always possible to prevent this condition, especially if it runs in your family or is a side effect of lifesaving care, like chemotherapy.

However, certain causes are manageable. You may be able to prevent dilated cardiomyopathy by:

• Avoiding cocaine.
• Consuming alcohol in moderation.
• Managing conditions like diabetes and high blood pressure.
• Taking good care of your heart to prevent a heart attack.

What is the outlook for people with dilated cardiomyopathy?

Your prognosis depends on the cause and severity of the disease. Many people return to work and daily activities after treatment. Advanced dilated cardiomyopathy or complications can make you severely ill. You may need to stay in the hospital until symptoms improve.

What’s important to know about living with dilated cardiomyopathy?

Dilated cardiomyopathy has no cure. But you can optimize your well-being by following care instructions. These include:

• Checking for signs of potential complications daily, such as sudden weight gain.
• Committing to lifestyle changes, like eating a low-sodium diet.
• Seeing your healthcare provider a few times a year for follow-up visits.
• Taking medications as prescribed.

A note from Cleveland Clinic

Dilated cardiomyopathy causes your heart’s main pumping chamber to expand. This decreases its ability to pump blood out to your body, putting you at risk for heart failure. The condition affects each person differently. Many people resume full, active lives with successful treatment and ongoing care.