Dilated Cardiomyopathy

The term “cardiomyopathy” refers to “cardio” (heart), “myo” (muscle), “pathy” (disease of). A dilated cardiomyopathy results in left ventricular chamber enlargement, systolic dysfunction and clinical manifestations of congestive heart failure.

While the strict definition of the term implies a non-ischemic etiology, the term “ischemic dilated cardiomyopathy” is sometimes used. The causes of non-ischemic dilated cardiomyopathy include:

1. Viral (Coxsackie B, influenza, HIV, enteroviruses)
2. Idiopathic (about 50% of cases)
3. Familial/genetic
4. Alcohol
5. Chemotherapeutic agents (most commonly daunorubicin and doxorubicin)
6. Selenium deficiency
7. Thyroid disease
8. Tachycardia mediated
9. Peripartum

The exact pathophysiology varies depending on the etiology, however they all share common physiologic changes of systolic congestive heart failure (see pathophysiology section).

The treatment is of a dilated cardiomyopathy is aimed at the cause if potentially reversible (i.e. selenium deficiency or tachycardia mediated) and towards blockage of the neurohormonal response as discussed in the systolic congestive heart failure review, section on treatment.