Dilated cardiomyopathy

I42.0

• Description
• Diagnostic criteria
• General and supportive measures
• Medicine treatment
• Referral

DESCRIPTION

Dilated cardiomyopathy is a clinical diagnosis characterised by dilation and impaired contraction of the left or both ventricles that is not explained by abnormal loading conditions. It is difficult and sometimes impossible to distinguish myocarditis from dilated cardiomyopathy. Dilated cardiomyopathy is often a sequel to viral myocarditis.

DIAGNOSTIC CRITERIA

Clinical

• Cardiomegaly with clinical signs of heart failure and poorly localised apical impulse.
• May present with cardiogenic shock.

Investigations

• Chest X-ray:
  • pulmonary congestion,
  • cardiomegaly,
  • there may be pleural effusion.
• ECG:
  • Mostly non-specific.
  • Dysrhythmias or extra-systoles may occur.

GENERAL AND SUPPORTIVE MEASURES

• Fluid restriction (75% of daily requirements) – not at expense of adequate caloric intake.
• Ensure adequate nutrition, tube-feeding may be necessary.
• Advise bed rest.

MEDICINE TREATMENT

To prevent hypoxia:

• Oxygen via face mask, nasal cannula or head box.

See Heart Failure .

REFERRAL

• Urgent: To ICU for inotropic support if indicated.
• All patients for assessment and consideration of underlying disorders.