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Dilated cardiomyopathy is a condition that mainly affects the left ventricle, the part of the heart that sends blood to the rest of the body via the aorta.
It is an enlargement of the ventricle, which is associated with a reduced ability to pump blood (‘systolic’ or ‘low ejection fraction’ heart failure).
Although it can be asymptomatic in some cases, dilated cardiomyopathy is a disease that, if left untreated, can over time lead to heart failure, a syndrome characterised by fluid accumulation in the lungs (pulmonary congestion), abdomen, legs and feet, mitral and/or tricuspid valve insufficiency (i.e. incontinence) secondary to ventricular dilation, embolisms, and arrhythmias that can also cause sudden death.
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In many cases it is not possible to trace the causes of the enlarged heart and dilated cardiomyopathy is therefore referred to as idiopathic.
There are several reasons why the heart can become enlarged: genetic mutations, congenital defects, infections, alcohol or drug abuse, certain chemotherapies, exposure to toxic substances such as lead, mercury and cobalt, and cardiovascular diseases such as ischaemic heart disease and high blood pressure.
Generally, the symptoms of dilated cardiomyopathy are those of heart failure or are due to arrhythmias and may include skin paleness, weakness, easy fatigability, shortness of breath during even modest exertion or when lying down, a persistent dry cough (particularly when lying down), swelling of the abdomen, legs, feet and ankles, sudden weight gain caused by water retention, loss of appetite, palpitations, dizziness or fainting.
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The risk of developing dilated cardiomyopathy can be reduced by avoiding smoking, consuming alcohol only in moderation, not using drugs, maintaining a healthy, balanced diet and regular exercise appropriate to one’s condition.
In the presence of symptoms of a possible dilated cardiomyopathy, the doctor may prescribe the following tests:
When the cause of dilated cardiomyopathy is known, it should, if possible, be removed or corrected. Regardless of the cause, therapy for heart failure should be instituted to improve symptoms and increase survival.
Currently, therapy for heart failure includes:
In more severe cases refractory to the above treatments: the implantation of left ventricular assist devices (LVAD) and/or heart transplantation.
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