dilated cardiomyopathy

Definition and epidemiology (JACC 2016;67:2996; Lancet 2017;390:400)

• LV or biventricular dilatation and global ↓ contractility ± ↓ wall thickness in the absence of ischemia/infarct, valvular disease or HTN. Pts w/ prior MI complicated by LV dilation and ↓ EF are often termed “ischemic CMP.”

etiologies of dilated cardiomyopathy

Clinical manifestations

• Heart failure: both congestive & poor forward flow sx; signs of L- & R-sided HF

diffuse, laterally displaced PMI, S3, ± MR or TR (annular dilat., displaced pap. muscle)

• Embolic events (~10%), supraventricular/ventricular arrhythmias, & palpitations

diagnostic studies and workup of dilated cardiomyopathy

Treatment (see “Heart Failure” for standard HF Rx)

• Possibility of reversibility of CMP may temper implantation of devices

• Prognosis differs by etiology (NEJM 2000;342:1077):

  • postpartum (best),
  • ischemic/GCM (worst)