What should be noted for dilated cardiomyopathy?

Written by Liu Ying
Cardiology
Updated on September 06, 2024
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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 Liu Yong
Cardiology
1min 53sec home-news-image

Does cardiomyopathy require surgery?

Firstly, whether myocardial disease requires surgery, we need to clarify the type of myocardial disease and the stage of myocardial disease, that is, the stage of heart function that has been affected. There are many types of myocardial diseases, including dilated cardiomyopathy, ischemic cardiomyopathy, and restrictive cardiomyopathy, for instance. The treatment plans for different types of myocardial diseases are not exactly the same. For example, dilated cardiomyopathy is generally treated with medication, and only in the very late stages of dilated cardiomyopathy, or what is known as stage IV heart function, when conventional medication is ineffective, heart transplantation might be considered if a donor is available and conditions allow. However, currently, heart donors are extremely rare, making this option quite difficult to achieve. The latest advances in clinical research have introduced artificial mechanical hearts available for transplantation, but the costs of surgery are very high, and the technology is not very mature yet. Therefore, the chances and opportunities for surgery are not very great and must be decided based on the situation. For other conditions, such as ischemic cardiomyopathy, if it is clearly caused by severe ischemia, we might consider addressing the factors causing myocardial ischemia, such as performing a coronary angiography. If there is severe coronary artery stenosis, we might consider implementing a coronary artery stent or coronary artery bypass grafting to alleviate the ischemic factors. In cases like restrictive cardiomyopathy, if there are severe restrictive factors contributing to the disease, surgical treatment might also be pursued.

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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 Li Hai Wen
Cardiology
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Is dilated cardiomyopathy more serious or is myocardial ischemia more serious?

This has to be judged comprehensively based on the following conditions: First, the age factor. If it occurs in young people, dilated cardiomyopathy tends to be more severe. This is because dilated cardiomyopathy is an organic heart disease, and myocardial ischemia in young people may not necessarily involve organic heart disease changes, but could also be normal physiological changes in the electrocardiogram. Second, whether there is concurrent cardiac function impairment. Dilated cardiomyopathy definitely involves impairment of the heart's pumping function, whereas myocardial ischemia does not necessarily involve such impairment. Therefore, in most cases, dilated cardiomyopathy is more serious.

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Written by Liu Yong
Cardiology
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Late-stage symptoms of dilated cardiomyopathy

The so-called advanced stage refers to a phase where cardiac function has reached stage four. The common clinical manifestations of this stage are primarily those of heart failure, such as chest tightness and shortness of breath after activity, inability to lie flat at night, general edema, and even accumulation of fluid in the chest and abdominal cavity. Some patients with severe edema might experience abdominal distension, poor appetite, and even malnutrition, which are all manifestations of heart failure. Once cardiac function reaches stage four, patients with dilated cardiomyopathy are highly susceptible to malignant arrhythmias, such as ventricular tachycardia and ventricular fibrillation. These types of arrhythmias are a common cause of death in the late stages of dilated cardiomyopathy. Therefore, proactive prevention is crucial for these patients as they have a very poor prognosis, and it is essential to maintain active communication with their families.

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Written by Li Hai Wen
Cardiology
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Clinical manifestations of dilated cardiomyopathy

The clinical manifestations of dilated cardiomyopathy can be summarized in two words: "three hearts," which are reflected in the following three aspects. First, heart enlargement, such as through chest X-rays or echocardiography, often reveals a notable enlargement of the patient's heart. Second, arrhythmias; dilated cardiomyopathy often accompanies a variety of arrhythmias, such as frequent ventricular premature beats, tachycardia, or atrial fibrillation. Third, heart failure. Dilated cardiomyopathy often results in symptoms of heart failure, such as exertional dyspnea and paroxysmal nocturnal dyspnea.