When the disease breaks down the main function of the heart muscle - contractile. It is weakened. At the same time diffuse (all sides) are expanding the chamber of the heart. Much less affected only one of the chambers of the heart. According to the statistics of dilated cardiomyopathy comprise 9% of all cases of heart failure. The incidence of dilated cardiomyopathy from 3 to 10 cases per 100,000 people.
The causes of this type of cardiomyopathy is not fully understood. It is considered a possible hereditary nature of disease, as is often found several cases of the disease in close relatives. Probably contribute to disease disorders of the immune system, but confirmation of this has been found in all patients. Many researchers believe the origin of viral dilated cardiomyopathy, however, to isolate the virus causing it no one has failed. The disease usually develops gradually. Sometimes people do not notice a few years of illness. And the extended contours of the left ventricle detected incidentally during x-ray study.
The first signs of the disease: they are not specific, ie on them can not be right to guess that this is cardiomyopathy. This fatigue on exertion, weakness. Later, there is shortness of breath, first load and then it increases and at the height of the disease appears cardiac asthma. Very often there are pains in the heart of the different nature: aching, stabbing, pinching. But angina is rare. Because that inner chambers of the heart and other extended until the end does not determine the cause is often in the cavity of the heart and veins occur in large clots. These clots can break off and fall into the bloodstream to the lungs. Then a terrible complication - pulmonary thromboembolism (PTE). In 33% of cases of sudden death was pulmonary embolism is the culprit.
On examination, the patient is found cold skin, expanding the borders of the heart. When listening to taped systolic murmur, and various arrhythmias. With a significant expansion of the left ventricular cavity and reducing the volume of ejected them because of the weakness of the heart muscle of blood - the patient's prognosis is poor.
The diagnosis of dilated cardiomyopathy established based on X-ray studies, electrocardiogram, angiography. But the main method of diagnosis of cardiomyopathy is echocardiography. If echocardiography reveals increased left ventricular enlargement other chambers of the heart, is determined by a normal or reduced thickness of the wall of the left ventricle. If you suspect a dilated cardiomyopathy echocardiography is carried out is mandatory. Already at the first examination established the diagnosis. In a subsequent survey conducted for the treatment and control of the heart. Maybe biopsy. Investigation under the microscope a small piece of heart muscle. There are extensive changes - the dead heart muscle cells, the replacement of muscle tissue at the junction (sclerosis of the heart muscle).
Treatment of Dilated cardiomyopathy
No specific treatment of cardiomyopathies. Treatment is aimed at combating complications. First of all, heart failure, which develops over time in all patients.
Patients are given advice on lifestyle changes: it is necessary to reduce physical activity, reducing salt intake, animal fat, eliminate bad habits. This reduces the load on the heart and slow the progression of heart failure.
Drug treatment is aimed at lowering blood pressure. For this purpose, angiotensin converting enzyme inhibitors (enalapril, berlipril, lisinopril, and others). These drugs reduce systemic blood pressure and reduce left atrial pressure, reducing stress on the heart. It is proved that their use increases the life expectancy of patients with dilated cardiomyopathy.
Sometimes used cardiac glycosides, and small doses of beta-blockers.
Almost all patients assigned to diuretics (diuretics). They reduce the amount circulating in the blood vessels.
When violations of heart rhythm medications must be appointed for the normalization of heart rate.
Because patients often form blood clots, prescribers, preventing thrombosis (aspirin, warfarin).
There may be cases where heart failure is not amenable to medical treatment, then the only way out is heart transplantation. The prognosis for this disease seriously. Gradually, in spite of treatment, cardiac function deteriorates. In the first 5 years from the onset of the disease kills about 70% of patients. However, there is evidence that regular monitoring and treatment of possible stabilization of the state in 20-50% of patients, and even better. Recovery in dilated cardiomyopathy is very rare. Female patients should avoid pregnancy, as this condition is very high maternal mortality.
