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Page 1 of 2 Dilated Cardiomyopathy
Dilated Cardiomyopathy, the most common form of heart muscle disease, occurs mostly in middle–aged people and more in men than women. However, the disease has been diagnosed in people of all ages, including children. Also called “Congestive Cardiomyopathy” it damages the muscle tissue that makes up the heart’s pumping chambers.
If the chamber walls become weak enough, the heart can no longer perform its normal pumping action adequately. Other parts of the body compensate for this deficiency in pumping power by increasing the quantity of fluid they retain – and by producing a greater volume of blood than usual. The heart chambers then dilate (expand) to accommodate the greater blood volume.
Bodily functions remain near normal over the short term. Early on, adequate circulation is maintained. Stretching of the heart muscle tissue to accommodate the increased blood volume can initially restore some of the heart’s pumping strength: the more a muscle is stretched, the more forcefully it may contract. Over the long term, however, the effects of continuing heart enlargement are not positive. The heart compensates by increasing its rate. The less efficient heart cannot contract as well, which results in poor circulation and causes excess body fluids to accumulate in the lungs, abdomen, and legs. This fluid buildup produces breathing difficulties and swelling (edema), two common symptoms of heart failure.
Causes
No exact cause can be determined for more than 80% of all cases of dilated cardiomyopathy, although viral infections may be responsible. Unfortunately, viruses are very difficult to detect in laboratory samples. Because the infection may have occurred months or even years before a person shows any sign of a weakened heart muscle, the precise initiating cause is difficult to pinpoint with certainty. When the cause is unknown, the cardiomyopathy is called idiopathic.
Other cases can be traced to the following causes:
- Alcohol and other toxic substances
After years of heavy drinking, the heart can be weakened by alcohol’s toxic effect on its muscle cells. Also, heavy drinkers tend to substitute alcohol for food, which leads to nutritional deficiencies. Other toxic substances, including some chemicals and pesticides, have also been shown to weaken the heart muscle. In addition, drug abuse can also weaken the heart muscle.
- Poor nutrition
Severe deficiencies in essential vitamins and minerals – especially Thiamine (also known as vitamin B–1) – may lead to dilated cardiomyopathy.
- Inflammation
In a rare condition called Myocarditis, the heart muscle becomes inflamed as a result of an infection by a virus, less often, by bacteria, or other infective processes. Persons may actually feel no symptoms at all, in other cases, they may feel acute chest pain and fatigue such as that associated with a bad cold or the flu. Usually, a mild case of myocarditis will disappear and cause no lasting damage. In fact, it may go completely undiagnosed. Severe cases are frequently not diagnosed until the symptoms of heart failure appear. Even a severe case may go away spontaneously, but intense bouts of inflammation usually cause progressive and irreversible heart muscle damage.
- Pregnancy and childbirth
In rare cases, a woman may develop heart muscle disease late in pregnancy or during the first few months after delivery. This is called Peripartum Cardiomyopathy. With or without having had a viral or bacterial infection, the woman develops an inflammation of her heart muscle. Researchers have not been able to determine why this happens. They do know that if the woman recovers from the disease and becomes pregnant again, she is again at risk for developing the condition.
- Heredity
Scientists haven’t identified an abnormal gene related to the development of dilated cardiomyopathy. However, many suspect that there may be a genetic link. They also point to instances in which the disease occurs within families. In addition, some genetic neurological disorders, such as muscular dystrophy, are associated with heart muscle impairments.
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