Dilated Cardiomyopathy
Dilated Cardiomyopathy (DCM): A Complete Patient Guide
Dilated cardiomyopathy (DCM) is a condition where the heart’s main pumping chamber (the left ventricle) becomes enlarged (dilated) and weakened, reducing its ability to pump blood efficiently around the body. Over time, this can lead to heart failure, irregular heart rhythms (arrhythmias), and other serious complications.
DCM can affect people of any age, including children, but it is most common in adults aged 20–60. Men are more frequently affected than women. In the UK, dilated cardiomyopathy is one of the leading causes of heart failure and is also a major indication for heart transplantation.
The causes of DCM are varied, including genetic mutations, viral infections, alcohol misuse, uncontrolled high blood pressure, and certain chemotherapy drugs. In many cases, however, no clear cause is identified, and the condition is referred to as idiopathic dilated cardiomyopathy.
Understanding the condition, recognising the warning signs early, and receiving timely treatment can greatly improve quality of life and prognosis.
The symptoms of dilated cardiomyopathy often develop gradually but may worsen over time as the heart becomes weaker. Common symptoms include:
Shortness of breath (dyspnoea): Especially during exertion or when lying flat.
Fatigue and weakness: Due to reduced oxygen supply to tissues.
Swelling (oedema): In the ankles, legs, feet, or abdomen, caused by fluid retention.
Rapid or irregular heartbeat (palpitations): Sometimes accompanied by dizziness or fainting.
Persistent cough or wheeze: Often worse at night due to fluid buildup in the lungs.
Chest discomfort or pain.
Reduced ability to exercise or perform daily activities.
Weight gain: From fluid retention.
Sudden cardiac arrest (rare but possible).
You should seek medical advice if you experience:
Unexplained shortness of breath, especially if it worsens at night or when lying down.
Palpitations, dizziness, or fainting spells.
Swelling in your legs, ankles, or abdomen.
A strong family history of cardiomyopathy, heart failure, or sudden unexplained death.
Emergency medical attention is needed if you experience:
Severe chest pain.
Sudden fainting.
Rapid or irregular heartbeats that don’t settle.
Severe shortness of breath with frothy sputum.
Diagnosing dilated cardiomyopathy requires a detailed evaluation by a cardiologist. Tests may include:
Medical history and examination – including family history, lifestyle factors, and risk assessment.
Echocardiogram (Echo): An ultrasound scan of the heart to assess chamber size, pumping function (ejection fraction), and valve function.
Electrocardiogram (ECG): Records electrical activity and can detect arrhythmias.
Cardiac MRI: Provides detailed images of heart structure and scarring.
Chest X-ray: Shows heart enlargement and fluid in the lungs.
Blood tests: Including BNP/NT-proBNP (markers of heart failure), thyroid function, iron levels, and viral or genetic screening.
Coronary angiography or CT scan: To rule out coronary artery disease.
Genetic testing: If there is a family history of cardiomyopathy.
Holter monitor (24–48 hours ECG): Detects abnormal heart rhythms over time.
There is no single cure for DCM, but treatment focuses on improving heart function, managing symptoms, and reducing complications.
1. Lifestyle Changes in dilated cardiomyopathy
Reducing salt intake to limit fluid retention.
Following a heart-healthy diet (low in saturated fat, rich in vegetables, fruits, lean protein).
Avoiding alcohol and recreational drugs.
Regular moderate exercise (as guided by your cardiologist).
Stopping smoking.
Managing stress and ensuring good sleep.
Medications
ACE inhibitors / ARBs / ARNIs (sacubitril/valsartan): To relax blood vessels and improve pumping.
Beta-blockers: To reduce strain on the heart and control arrhythmias.
Diuretics: To reduce fluid retention and swelling.
Mineralocorticoid receptor antagonists (spironolactone, eplerenone): Improve outcomes in heart failure.
SGLT2 inhibitors (dapagliflozin, empagliflozin): Newer drugs shown to reduce hospitalisation and improve survival.
Anticoagulants: To prevent blood clots in patients at high risk.
3. Devices and Surgical Options
Implantable cardioverter-defibrillator (ICD): For patients at risk of sudden cardiac death.
Cardiac resynchronisation therapy (CRT): A special type of pacemaker to improve heart pumping efficiency.
Left ventricular assist device (LVAD): A mechanical pump to support heart function in advanced cases.
Heart transplant: Considered for patients with severe, treatment-resistant disease.
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.
Living with dilated cardiomyopathy
Living with dilated cardiomyopathy requires long-term medical follow-up and lifestyle adaptation:
Regular check-ups: Monitoring heart function and adjusting medications.
Daily weight monitoring: To detect fluid retention early.
Symptom tracking: Report worsening breathlessness, swelling, or palpitations promptly.
Vaccinations: Flu and pneumonia vaccines are recommended.
Emotional wellbeing: Support groups and counselling may help with anxiety or depression.
Family screening: Relatives may also need testing if the condition is genetic.
Lifestyle with DCM
Reducing salt intake to limit fluid retention.
Following a heart-healthy diet (low in saturated fat, rich in vegetables, fruits, lean protein).
Avoiding alcohol and recreational drugs.
Regular moderate exercise (as guided by your cardiologist).
Stopping smoking.
Managing stress and ensuring good sleep.
The outlook for patients with dilated cardiomyopathy varies widely. Prognosis depends on the cause, severity of heart dysfunction, response to treatment, and presence of complications like arrhythmias.
With modern treatments, many patients can live for years with good quality of life. However, some may progress to advanced heart failure requiring transplantation or mechanical support. Early diagnosis, adherence to medication, and lifestyle modification are key to improving outcomes.
- DCM is the most common type of cardiomyopathy worldwide.
- It can be inherited or acquired.
- Around 1 in 250 people may have some form of DCM.
- The condition weakens the heart’s ability to pump blood.
- It is a leading cause of heart failure and sudden cardiac death.
- Symptoms may be subtle at first but worsen over time.
- Genetic testing may be recommended for family members.
- Modern medications (including SGLT2 inhibitors) have improved survival.
- Devices like ICDs and CRT pacemakers reduce risks in advanced cases.
- Heart transplantation remains a last resort for severe, unresponsive cases.
- What is the likely cause of my dilated cardiomyopathy?
- How severe is my heart function impairment?
- What treatment options are best for me?
- Do I need an ICD or pacemaker?
- What lifestyle changes will make the biggest difference?
- Should my family members be screened or tested?
- What are the risks of sudden cardiac death in my case?
- How often will I need follow-up tests?
- Am I eligible for advanced treatments like LVAD or transplant?
- What is my long-term outlook with treatment?
Share with others:
