Dilated cardiomyopathy clinical manifestations

Written by Liu Yong
Cardiology
Updated on September 20, 2024
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Dilated cardiomyopathy is a type of heart disease characterized clinically by a significant enlargement of the heart, a marked reduction in ejection fraction, and a significant decline in heart function. Common clinical manifestations of this disease often present as heart failure symptoms, including chest tightness and shortness of breath after activity, nocturnal paroxysmal breathing difficulties, inability to lie flat, as well as swelling of the lower limbs and abdominal wall, and even conditions such as pleural effusion and ascites. Additionally, it may be associated with various types of arrhythmias, such as premature beats and tachycardia, especially ventricular tachycardia, which are all manifestations of dilated cardiomyopathy.

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Written by Li Hai Wen
Cardiology
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Which department should I register for cardiomyopathy?

Cardiomyopathy is a common disease in our daily lives, characterized primarily by changes in the myocardium. After being diagnosed with cardiomyopathy, many patients often ask which department they should register with at the hospital. Generally speaking, cardiomyopathy falls under cardiovascular diseases, so registration should be with the department of cardiology. Cardiologists often prescribe a cardiac echocardiogram to diagnose myocardial diseases. Conditions such as hypertrophic cardiomyopathy or dilated cardiomyopathy require a cardiac echocardiogram for detection, which is the most commonly used examination for cardiomyopathy.

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Written by Tang Li
Cardiology
1min 15sec home-news-image

Treatment of Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, due to unknown causes and often related to genetic factors, is difficult to prevent. It is important to guide patients on how to lead their lives, reminding them to avoid intense physical activities, heavy lifting, or breath-holding to reduce the incidence of sudden death. Avoid using drugs that enhance myocardial contractility and reduce cardiac capacity load, such as digoxin and nitrates, to decrease the aggravation of left ventricular outflow tract obstruction. The treatment principle for this disease is to slow down the hypertrophy of the myocardium, prevent tachycardia, and maintain normal sinus rhythm. It also aims to relieve the narrowing of the left ventricular outflow tract and counteract arrhythmias. Currently, the use of beta blockers and calcium channel blockers is advocated. For severe obstructive patients, interventional and surgical treatments can be carried out, including the implantation of a dual-chamber DTD pacemaker, and the ablation or removal of hypertrophied interventricular septum myocardium.

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Written by Liu Ying
Cardiology
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What should be noted for dilated cardiomyopathy?

Patients with dilated cardiomyopathy should actively look for the cause of the disease and provide corresponding treatments, such as controlling infections, strictly limiting or abstaining from alcohol, treating relevant endocrine or autoimmune diseases, correcting electrolyte disorders, and improving nutritional imbalances, etc. In the early stages of dilated cardiomyopathy, although there is already enlargement of the heart and impairment of contractile function, there are no clinical manifestations of heart failure. At this stage, early pharmacological intervention should be actively implemented to slow down ventricular remodeling and further damage to the myocardium, delaying the progression of the disease. As the condition progresses, the patient's ventricular contractile function further decreases and clinical manifestations of heart failure appear. At this point, treatment should follow the guidelines for chronic heart failure. However, the specifics of the treatment and the choice of medication should be determined by a specialist based on the patient’s condition.

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Written by Tang Li
Cardiology
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How is hypertrophic cardiomyopathy treated?

The treatment of hypertrophic cardiomyopathy aims to improve symptoms, reduce complications, and prevent sudden death. The methods include improving ventricular compliance by reducing outflow tract obstruction, preventing thromboembolic events, and identifying high-risk patients for sudden death. Treatment needs to be individualized, and the main treatments include the following aspects: 1. Medication treatment. Drug treatment is fundamental, and drugs targeting outflow tract obstruction mainly include receptor blockers and non-dihydropyridine calcium channel blockers. For patients with congestive heart failure, targeted treatment is required. Anticoagulation treatment is necessary for patients with atrial fibrillation, and it is worth noting that for patients with chest discomfort, care should be taken to exclude outflow tract obstruction when using nitrate drugs to avoid exacerbation after use. Non-drug treatments include: 1. Surgical treatment: For patients with ineffective drug treatment and heart function class three to four, if there is severe outflow tract obstruction, septal myectomy should be considered. Currently, surgery is listed as the preferred treatment for suitable patients in consensus guidelines in both America and Europe. 2. Alcohol septal ablation; 3. Pacing therapy.

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Written by Zhang Yue Mei
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What should patients with cardiomyopathy pay attention to?

Patients with cardiomyopathy need to rest adequately, avoid overexerting themselves, and not get overly emotional to keep their mood calm and prevent an increased burden on the heart, which could trigger heart failure. In their diet, they should consume easily digestible foods that are high in superior protein and eat plenty of fruits and vegetables. These foods can provide the high-quality proteins, vitamins, and trace elements needed by the body, enhancing immunity and disease resistance. In the event of thrombosis and myocardial cell repair, systematic medication treatment under a doctor's guidance is essential to promote myocardial repair.