Dilated cardiomyopathy is not included in the list of well-studied diseases. It is especially difficult to find out the causes of the onset of the disease. There are some assumptions, supported by scientific works, but the etiology itself is still being studied.
Doctors can only recommend and suggest risk groups, according to statistics. In this case, the causes of the symptoms themselves are still unclear. Nevertheless, based on the number of patients and the treatment process, some conclusions can be made that will help reduce the likelihood of this ailment. In Western medicine, it is customary to identify five causes of dilated cardiomyopathy:
Unfortunately, in thirty percent of cases, the disease is inherited. In general, every third patient with a similar disease has one of the closest relatives with the same diagnosis.
The toxic reason is much more prosaic – alcohol. Increased doses of ethanol provoke damage to contractile proteins, and violates the necessary level of metabolism. Moreover, not only alcohol is included in this group. Toxic lesions also include occupational diseases. People in contact with industrial dust, metals and harmful substances are also in the second risk group.
Elementary malnutrition, protein deficiency, and a lack of basic vitamins also provoke a risk of illness. However, such manifestations are possible only with a very long wrong lifestyle. This is very rare in medical cases.
For example, a person for about ten years had problems with proper nutrition, sleep patterns, as a result of which he had a malfunction, which entailed the occurrence of dilated cardiomyopathy, but such cases account for less than 5 percent of all cases. However, they usually come to the treatment of dilated cardiomyopathy, still having a concomitant bouquet of diverse, not only heart diseases.
- Symptoms of pathology
- Vivid and secondary symptoms of heart disease
- Pathogenesis of the disease
- What happens with an illness
- Causes and symptoms
- Treatment and prognosis of dilated cardiomyopathy
- Symptoms of pathology
- Cardiac disease treatment
- Symptomatology of the disease
- Preventive measures
- Features of food
- Lifestyle for patients with cardiomyopathy
- Types of pathology
- preventive measures
- Features of food
Symptoms of pathology
Congestive cardiomyopathy is classified according to the cause of this disorder. There are secondary and idiopathic dilated cardiomyopathy.
Secondary dilated cardiomyopathy has certain causes. Changes in heart muscle with this form of the disease occur as a consequence of the underlying disease. That is, the root cause is a completely different disease: a viral infection, pneumonia, severe intoxication with alcohol, drugs, heavy metal salts, diabetes mellitus, pancreatitis, cirrhosis, vitamin deficiency, metabolic disorders and others. The secondary form of this disease is classified for the reasons for its occurrence, namely:
- Alcoholic When drinking alcohol, especially strong drinks, ethanol damages myocardial cells, which leads to muscle strain. More common in men who abuse alcohol. Alcoholic cardiomyopathy develops myocardial dystrophy.
- Toxic and medical. The muscle is exposed to the negative effects of the elements that make up the medication, for example, cadmium, lithium, arsenic, cobalt, isoproterenol. Under the influence of these elements, microinfarctions occur in the heart muscle, and then inflammation.
- Metabolic. Hyperthyroidism, diabetes mellitus, kidney disease, Addison’s disease, Itsenko-Cushing’s disease, frequent vomiting disrupt metabolic processes, the myocardium thus suffers from insufficient amounts of thiamines and other vitamins.
- Caused by diseases of the digestive system (malabsorption, pancreatitis, cirrhosis and the like).
- Caused by diseases of the connective tissue (rheumatoid arthritis, systemic lupus erythematosus, scleroderma, psoriasis and the like).
- Caused by neuromuscular diseases (myotonic and muscular dystrophies, Friedreich’s ataxia and others).
- Infectious. Arising as a complication due to a virus, bacterial infection or parasites.
- Caused by myocardial infiltration. In the course of diseases such as carcinomatosis, leukemia, sarcoidosis, the muscle is subject to strong negative consequences, which can lead to its stretching.
Idiopathic dilated cardiomyopathy is characterized by a violation of the systological function of the heart chambers and stretching of its muscles. The idiopathic nature of any disease in medicine means that the disease arose independently, regardless of any lesions. It is not possible to establish the cause of the occurrence of such a disease, because it was not subsequently caused by any other disease or the influence of negative factors.
Cardiologists note that this form of dilated cardiomyopathy occurs in 5 to 8 people out of 100000. The spread of this disease has been increasing recently, but doctors make such conclusions only on the basis of diagnosed cases, and the real picture may be completely different. Often the disease manifests itself with minor symptoms or no symptoms at all.
According to statistics, every year an increasing number of people become owners of various heart diseases, which can leave an incorrigible mark, and sometimes lead to death. In matters of health, awareness, a clear understanding of various diseases, the ability to diagnose them in oneself and knowledge of how to avoid these diseases are always very important.
In this article, we will talk about one of the most common heart diseases – cardiomyopathy.
Cardiomyopathy is a general definition that combines a group of diseases that cause damage to the muscle areas of the heart. The consequences of cardiomyopathy are quite serious, it can be arrhythmia, failure, and much more.
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Dilatation or congestion – the organ increases, cardiac activity and the frequency of myocardial contractions decrease. In most cases, it is found in young people and is a consequence of infections, intoxications and impaired functioning of various body systems.
Hypertrophic (asymmetric, symmetric, obstructive, non-obstructive) – the myocardium thickens, and the chambers of the ventricles of the heart, on the contrary, decrease. It is a hereditary disease that develops in men in different age categories. It entails various types of hypertrophy of the heart muscles, the interventricular septum thickens.
Restrictive (obliterative, diffuse) – is quite rare, with it begins endocardial fibrosis, disruption of the ventricle and hemodynamics. Despite this, contractility persists, hypertrophy is absent.
Arrhythmogenic – A rare disease during which cardiomyocytes are replaced by adipose or fibrous tissue. This causes arrhythmia and fibrillation.
Causes for this disease can be inherited factors, apotosis, viruses, and chemicals. The disease develops in youth and is characterized by shortness of breath, tachycardia, dizziness and fainting.
Symptoms of cardiomyopathy vary and depend on its type and degree. In most cases, this is shortness of breath, sweating, swelling, heart pain, fatigue and blueness of the skin. Sometimes dizziness, loss of consciousness, fainting, and vomiting are added to the above.
The causes of cardiomyopathy are very different. Sometimes the wrong lifestyle leads to the appearance of the disease, and sometimes the disease is hereditary and appears due to the tendency of genes to do this:
- Viral diseases
- The consequences of heart disease
- Intoxication of the body
- The effect of allergens
- Changes in the endocrine system and endocrine regulation
- Immune System Problems
- Alcohol addiction
Complications after cardiomyopathy can be any kind of heart disease, heart failure, thrombosis, impaired conduction of the heart, arrhythmia, and even sudden death syndrome due to cardiac arrest.
Cardiomyopathy is diagnosed in a hospital or clinic. After the initial examination or questioning, the doctor can give direction to the necessary types of diagnosis.
Most often they use an electrocardiogram, magnetic resonance imaging, sounding, X-ray of the lungs and an echocardiogram, the data from which are most often the most informative, but it is all these examinations in the compartment that can show the full picture of the disease and affect the choice of the right treatment.
Special therapy does not exist, because of this, any measures are used to prevent dangerous complications and help maintain the optimal condition of the patient.
When the disease is stable, the patient is treated at home, but under the supervision of a doctor. Routine hospitalization and examination are regularly carried out to make sure that the patient’s condition does not get worse.
Patients with cardiomyopathy need to limit physical activity and active movement, and also adhere to a diet that is individually prescribed by each doctor. Usually, such a diet consists in reducing the amount of fats and salts in the diet.
What medications can a cardiologist prescribe for cardiomyopathy?
- Glycos >
In the most complex and neglected cases, they resort to surgical intervention. If cardiopathy is accompanied by other heart diseases, then the patient needs a heart transplant.
The heart is the most important organ, any interference can lead to very unpleasant consequences or death, therefore it is very important to regularly check the state of your heart, visit a cardiologist and do an electrocardiogram.
You can avoid cardiomyopathy, you just need to lead a healthy lifestyle, do not abuse alcohol, do not overload the body too much and keep it in good shape.
Since each type of disease has its own mechanism of development and progression, the symptoms of cardiomyopathy will differ.
If a person has an obstructive form of this disease (that is, the diameter of the hole from which the aorta originates is reduced), signs of insufficient blood supply to the brain develop:
- bouts of dizziness;
- shortness of breath
If an obstructive form occurs, cardiomyopathy may persist asymptomatically for a long time. Then it can develop and progress pretty quickly:
- shortness of breath, which at first accompanies only physical activity, but then appears at rest;
- edema – initially only on the legs, then higher;
- heaviness in the right hypochondrium;
Violation of the rhythm with this pathology is not always felt subjectively, but they are dangerous. Among male athletes, there are times when fibrillation developed suddenly and caused sudden death.
The main sign of this disease is the expansion of the chambers of the heart due to thinning of the myocardium. Therefore, heart failure will progress here:
- shortness of breath: first with severe, then with minimal physical exertion;
- pallor of the skin;
- swelling on the legs, then accumulation of fluid develops in the abdominal cavity and around the lungs (in the pleural cavities);
- increased blood pressure – this is how the body tries to compensate for the insufficient supply of oxygen to important organs, including the brain (read about the norm of blood pressure);
- the skin under the nail plates acquires a bluish tint;
- neck veins become noticeable;
- heart pain that does not disappear with nitroglycerin.
Alcoholic cardiomyopathy also has similar symptoms, which is dilatational in nature, arising from the toxic effects of ethanol itself, as well as its decomposition product, acetaldehyde, into the heart muscle. Here in the initial stage of the disease after taking alcohol the next day arise:
- pains in the heart, which have a piercing-aching character, last for several hours, are not relieved by nitroglycerin;
- a feeling of interruption in heart work.
As the pathology progresses, such symptoms intensify the day after the libation; they do not go away even if a person abstains from alcohol for several days or weeks. Any emotional and physical stress can provoke them. Subsequent progression of the disease occurs during an alcoholic excess or within a few days after it.
Vivid and secondary symptoms of heart disease
The insidiousness of this type of heart disease lies in the fact that more than half of patients have no complaints of deteriorating health. In this case, only an annual medical examination can help. However, without pain in the region of the heart, few go voluntarily to in-depth studies of the heart muscle.
Chest pain is a sign of illness.
First of all, the following symptoms should alert:
- dry cough without signs of SARS;
- asthma attacks;
- pain behind the sternum is characteristic.
Less than ten percent of patients report particular pain in the right hypochondrium. In part, it resembles signs of appendicitis or acute poisoning. Severe swelling of the legs is possible. For any of the above symptoms, you should immediately consult a doctor. It is far from a fact that dilated cardiomyopathy will be indicated in the diagnosis, but in any case, such health problems will not plague a completely healthy person, which means that you need to start monitoring the body.
Pay special attention to your condition at night. With cardiomyopathy, the body suffers mainly during sleep. It is quite possible attacks of cardiac asthma. In addition, a dry cough will haunt when lying down. The same goes for pronounced suffocation.
Edema of the legs appears only at night, and in the morning they tend to subside. Pain in the right hypochondrium occurs due to a stretching of the liver capsule.
In a separate group of symptoms, it is customary to distinguish problems from the heart muscle. According to statistics, 90% of patients have various heart problems. Over time, they will manifest themselves more strongly, provoking the risk of sudden death.
In most cases, atrial fibrillation is recorded. There is a risk of developing other arrhythmias. For example, ventricular, as the disease directly affects the left ventricle.
If at the first stage of the disease it is difficult to diagnose it, then in advanced cases, unfortunately, only very irresponsible people ignore pronounced symptoms. Here already often we are talking about emergency care, without which a person can die at any time. The forecast will be very unfavorable. Of course, dilated cardiomyopathy does not have to be fatal, but the risk is very high.
A patient with advanced disease can no longer live a normal life. He is constantly worried about various pains. In particular, he cannot sleep, as he suffocates and often tries to fall asleep in a sitting position. Due to stagnation of blood in the lungs, the patient’s breathing is noisy and with severe wheezing. Edema not only affects the limbs, but also gradually passes to the whole body.
Often in such patients, constant shortness of breath and discomfort from any sudden movements. It is urgent to consult a doctor, since, in addition to sudden death, disability and a very difficult rehabilitation period are possible. In some cases, the ability to service yourself is completely lost and the patient becomes dependent on others without leaving the bed.
Statistics say that a ten-year survival rate for heart transplants averages over seventy percent. This is the most extreme way to solve the problem. Not many people, even in a critical situation, decide on such an operation, and financially it is very expensive.
With such an intervention, the patient’s own heart can be completely removed. The heart is replaced by a donor. It is important to understand that for modern doctors, heart transplantation is a chore. The average survival of patients without complications is a little over ten years. There is even a peculiar world record. In the United States, the patient lived for more than thirty years with a transplanted heart and did not die of heart failure, but became a victim of skin cancer.
Dilated cardiomyopathy holds the lead in diseases in which emergency cardiac transplants are used. In more than 50% of cases, transplantation of a vital organ is performed precisely with this disease.
There are a number of contraindications for this operation. In individual cases, exceptions are possible, but usually doctors do not risk resorting to surgical intervention when it comes to patients:
- over 65 years old;
- with active infection;
- having a malignant formation;
- abusers of alcohol and smoking;
- having a survival prognosis of less than three years.
In the above cases, heart transplantation is contraindicated in most medical institutions. However, many cases are resolved individually. Some doctors are ready to take the risk for the patient’s life if he takes full responsibility for his health during and after the surgery.
Pathogenesis of the disease
As a result of the action of etiological factors on the heart with a diagnosis of dilated cardiomyopathy, cardiomyocytes are damaged and the number of functioning myofibrils decreases. This leads to the progression of heart failure, which is expressed in a significant decrease in myocardial contractile functions with the subsequent development of dilatation.
As a result of pathological processes, a critical decrease in the pumping functions of the heart occurs, diastolic pressure in the ventricles increases and myogenic dilatation with tricuspid valve insufficiency is formed. Increased activation of the neurohormonal system of the body leads to significant myocardial damage and disorders of the blood coagulation system with the subsequent development of blood clots and thromboembolic complications. Now we find out what are the symptoms of the described pathology.
What happens with an illness
Cardiomyopathy is a group of pathologies that are accompanied by malfunctions in the functioning of the heart muscle. There are several mechanisms of myocardial damage that combine such diseases.
The reasons for the development of cardiomyopathy are most often unclear, and diagnosis requires the absence of congenital malformations. There are various types of such pathology, and the classification of cardiomyopathies depends on the characteristics of circulatory disorders in the heart.
Cardiomyopathy is a collective definition for a group of myocardial pathologies of unknown origin. The basis of such diseases is dystrophic and sclerotic processes in heart cells – cardiomyocytes. With such a violation as cardiomyopathy, in most cases, the work of the ventricles of the heart changes.
To date, it has not been possible to establish the true causes of cardiomyopathy. Experts argue that such pathologies can progress due to mutational changes in the genes or as a result of the active development of existing diseases in humans.
Such diseases can be diagnosed in people of absolutely any age, but in children they are detected much less often than in adults.
This is due to the fact that such a group of diseases is hereditary, and problems with the work of the heart can already appear in young children.
Causes and symptoms
Cardiomyopathies include any pathology that is accompanied by damage to the heart muscle. In fact, there are many reasons that can provoke the development of such an ailment.
In the event that malfunctions in the myocardium are a consequence of other diseases detected in humans, then they speak of secondary or specific cardiomyopathies. Otherwise, the root cause of the development of cardiomyopathy cannot be identified, and doctors are talking about the primary form of the disease.
The most common causes of cardiomyopathy are:
- congenital disorders often become one of the reasons for the development of cardiomyopathies, that is, at the stage of embryo tissue laying, various failures occur
- acquired causes are a consequence of the progression in the human body of various viruses, toxic substances and metabolic problems
- mixed causes combine several factors that caused the development of cardiomyopathy
Often, the disease is detected in children, and it can be either congenital or acquired. Secondary pathology develops as a result of exposure to the organ of external and internal factors, as well as another disease.
The most common secondary causes are:
- long-term diets, with the observance of which the content of nutrients and vitamins in the human body is reduced
- improper and irrational nutrition, overweight and pathology of the gastrointestinal tract
- disruptions in the metabolism in the myocardium as a result of pathologies of the endocrine system
- drinking a lot of alcohol
- taking medications and especially anti-tumor
- accumulation in cells of various pathological inclusions
In recent years, mortality due to secondary cardiomyopathy has been a common occurrence. The reasons for the development of such a pathology are diverse and in each individual case, a qualitative and professional examination is required.
Signs of cardiomyopathy have much in common with the clinical picture of progressive heart failure.
Medical practice shows that with such an ailment, patients most often complain of:
- increased body fatigue
- persistent swelling of the extremities
- paroxysmal pain in the heart
- weakness and dizziness
- shortness of breath
- trouble sleeping
The appearance of such symptoms indicates that a person has impaired cardiac contraction and problems with his blood supply. If such symptoms occur, you should consult a doctor as soon as possible, which will allow you to take timely measures.
In the study of such cardiac pathologies, scientists were able to establish their individual classification, according to which they are divided into two types: primary and secondary.
According to the atomic and functional changes in the myocardium, several types of cardiomyopathies are distinguished
In the event that it is not possible to identify the cause of the development of the pathology, then the primary ailment is diagnosed, which is classified into the following types:
- Restrictive cardiomyopathy. Such a violation is accompanied by myocardial rigidity, when a small volume of blood fills the heart chamber. The consequence of this pathological condition is the occurrence of diastolic dysfunction and heart failure. Mutations of a genetic nature are considered the main cause of restrictive cardiomyopathy.
- Hypertrophic cardiomyopathy. For such a pathology, a thickening of the wall of one of the ventricles is characteristic without a pronounced expansion of the cardiac cavities. The main reason for the development of such an ailment is various genetic defects. Hypertrophic cardiomyopathy is divided into symmetric, obstructive, nonobstructive, apical, and asymmetric. Medical practice shows that most often hypertrophic obstructive cardiomyopathy is detected in patients.
- Dilated cardiomyopathy. This type of ailment is characterized by various malfunctions in the contractile function of the heart due to the dilatation of its chambers. The development of this type of pathology is explained by immune and genetic disorders.
In the event that during the diagnosis it was not possible to identify the cause of the development of the disease, then they speak of secondary cardiomyopathy. In fact, it is more dangerous to human life than primary. Experts say that often the main cause of death is precisely secondary cardiomyopathy, which progresses in the human body in a severe form.
The secondary type of disease is divided into the following types:
- Alcoholic cardiomyopathy. This type of pathology is characterized by severe organ damage as a result of prolonged use of alcoholic beverages. A characteristic manifestation of such a disease is heart failure, and sometimes myocardial ischemia. Often it is alcoholic cardiomyopathy that causes death.
- Toxic cardiomyopathy. The appearance of problems in the work of the heart is associated with a prolonged exposure to the human body of any strong toxins.
- Ischemic cardiomyopathy. Myocardial disease provoked by various diffuse morphofunctional disorders that arise as a result of chronic or acute myocardial ischemia. For this type of ailment, heart failure and dilatation of the heart chambers are characteristic.
- Dyshormonal cardiomyopathy. Such a pathology is accompanied by a non-inflammatory lesion of the heart muscle, which occurs when the content of sex hormones is insufficient due to various metabolic disorders in the myocardium.
- Dysmetabolic cardiomyopathy. Such heart failure begins to progress against a background of prolonged overstrain of the organ and as a result of a violation of the homeostasis of the body. Most often, this type of pathology is diagnosed in young patients who are actively involved in sports.
- Metabolic cardiomyopathy. Such pathology is characterized by myocardial dystrophy and insufficiency of cardiac function, which arises as a result of failures in metabolic and energy-forming processes in the myocardium.
- Cardiomyopathy Takotsubo. Such a disease refers to non-ischemic species, is expressed by heart failure and the occurrence of pain in the chest. Strong emotional stresses are cons >
In addition to all of the listed species, there is another form of such a pathology – cardiomyopathy, unspecified. It is characterized by the emergence of certain specific states that cannot be attributed to any of the existing species.
Ultrasound is considered the most effective method for the diagnosis of cardiomyopathy.
When diagnosing cardiomyopathies, special attention is paid to the clinical picture of the disease and the indicators of instrumental studies. Today, ultrasound is considered the main way to detect various cardiac abnormalities.
In order to diagnose a specific type, doctors widely use the following diagnostic methods:
- CT scan
When a patient identifies one or another type of disease, the drug therapy of cardiomyopathy is selected first. The administration of diuretics is prescribed, which allows to reduce pulmonary and systemic venous congestion.
To help cardiac glycosides resorted to in identifying problems with myocardial contractility and impaired pumping function.
Taking antiarrhythmic drugs helps to adjust the heart rate, and treatment with anticoagulants and antiplatelet agents helps to eliminate thromboembolic complications.
Given the severity of the pathology and its nature, other more radical methods of therapy can be used:
- surgery can be performed for various types of cardiomyopathy, but in most cases it is used to eliminate hypertrophic obstructive heart disease
- stem cell treatment is most often performed if a patient has dilated cardiomyopathy
- heart transplantation is carried out only in extremely advanced cases
To date, medicine has not yet been able to develop a universal treatment regimen for such complex heart diseases. Timely medical assistance can make life easier for patients and prolong it for a long time, but at the same time, the mortality rate remains at a high level.
The worst risk is sudden death from heart failure. Other complications include:
- disturbances in the rhythm and conduction of the heart;
- blood clots in the heart;
- ventricular tachycardia;
- ischemic stroke.
Lack of treatment is a sure way to death. When ignoring the symptoms of the disease, the patient gradually forms blood clots in the heart. Over time, platelets become clogged by large arteries and provoke an ischemic stroke.
In the case of ventricular tachycardia, sudden ventricular fibrillation is possible. Without the lack of necessary medical care, a person risks a sudden cardiac arrest.
Treatment and prognosis of dilated cardiomyopathy
Pathology is often found in babies, and it mainly occurs against the background of other heart diseases. The peculiarity is that the disease proceeds gradually, so parents go to the doctor when the problem begins to pose a serious threat to the health and life of the child. In infants, the problem can be manifested in insufficiently rapid weight gain and difficulties in the feeding process, in particular, inability to suckle for a long time due to lack of oxygen.
The danger of the disease lies in the fact that at any time there is a chance that a blood clot in one of the large arteries will come off the wall and provoke a heart attack of the kidney or lung or a stroke. Avoid this development of events will allow regular monitoring by a pediatric cardiologist in the presence of any cardiovascular pathology.
Cardiopathy can cause the patient to die suddenly. This happens as a result of heart failure. The cause may be tachycardia, ventricular fibrillation. When a heart with dilated cardiomyopathy stops, restarting it is difficult, but possible. In addition, such patients are very likely to form blood clots, which means that a heart attack or stroke can suddenly occur with a patient. Blood stasis can lead to pulmonary edema, and from there their complete dysfunction will follow.
Against the background of many cardiological diseases, an expansion of the cavities of the heart can occur without an increase in its walls, which leads to the development of systolic dysfunction. This disease is called dilated cardiomyopathy.
The consequences of this pathology are very dangerous for a sick person: cardiopathy can lead to the development of chronic, rapidly progressive congestive heart failure, to impaired conduction and heart rhythms, which can result in sudden death at an early stage.
One of the clinical forms of cardiomyopathy – dilated cardiomyopathy (DCMP) – is a disease based on distension of the heart and the subsequent dysfunction of the ventricles, or just the left ventricle. Synonyms of pathology are congestive or congestive cardiomyopathy.
In order for the human heart to contract normally, and the tissues of the body to be completely satisfied regarding the need for the blood that comes to them, many conditions must be observed.
First of all, the heart walls should have a normal thickness, and the heart chambers should have the correct sizes.
For a number of reasons, biochemical processes in the myocardium are violated, as a result of which the volume of the heart chambers increases, or the wall thickness – cardiomyopathy occurs.
With hypertrophic cardiomyopathies, they grow in the thickness of the walls of the chambers, with dilatation, the volumes of the chambers.
Due to the subsequent overcrowding of the cavities with blood, systolic dysfunction occurs – a decrease in the contractile strength of the ventricles and a decrease in the intensity of the ejection of blood into the aorta.
The ejection rate is more than 50%, with dilated cardiomyopathy, this figure does not exceed 45%. The result of DCMP is the occurrence of congestive progressive heart failure.
The disease is rare in children and the elderly, but in most cases it is observed in people aged 20-50. In the vast majority of cases, the disease overtakes men (up to 88% of the total).
Its prevalence is low – about 1-9 people per 100 thousand people per year.
The classification of DCMP due to the occurrence is as follows:
- congenital (primary);
- acquired (resulting from transferred heart or systemic diseases), or secondary;
- idiopathic – for no established reason.
Another classification includes family (genetic) as well as non-family (non-genetic) forms.
There are several theories according to which the patient develops signs of dilated cardiomyopathy.
Up to 30% of all cases of DCMP are caused by burdened heredity, and pathology is transmitted, mainly, according to the autosomal dominant type, occasionally – according to the autosomal recessive type of inheritance.
Dilated cardiomyopathy is part of a complex of abnormalities that form some congenital syndromes, such as Bart syndrome. If the pathology is due to genetic factors, it has the most unfavorable prognosis.
Thanks to modern research, the role of viral infection in the development of cardiomyopathy has been studied. Using a PCR and ELISA assays, a significant part of the patients revealed viruses such as:
- hepatitis C;
- Coxsackie V viruses, etc.
Exposure to viral particles can trigger the launch of autoimmune processes or direct damage to myocardial cells, as a result of which a person develops DCMP.
In some patients, circulating immune complexes – cardiospecific antibodies are found, more often this is observed in people who already have other autoimmune pathologies.
With regard to direct damage by viral particles of myocardial cells, we are talking about transferred viral myocarditis, which in itself can lead to the emergence of DCMP. There is also evidence of a harmful effect on the myocardium of certain bacteria and fungi, parasitic diseases (for example, Chagas disease).
A history of some patients has alcoholism and even relatively moderate alcohol consumption.
Researchers suggest that in the presence of a genetic location, some people are highly susceptible to damage from myocardial cells toxins by ethanol, in connection with which metabolism in the tissue of the heart muscle is disrupted, pathological phenomena occur.
Other risk factors for the development of dilated cardiomyopathy may include:
- vitamin deficiency of B vitamins;
- protein deficiency in nutrition;
- lack of selenium, carnitine;
- neuromuscular diseases;
- pathology of connective tissue;
- multiple pregnancies;
- pregnant age over 35 years old;
- late toxicosis during pregnancy (preeclampsia);
- belonging to the black race.
Often, the causes of DCMP remain unclear, so it is recognized as idiopathic (up to 25-30% of cases).
Symptoms of pathology
While the cardiac function is compensated, the clinic of the disease does not appear at all. This can last several months, and sometimes years. But with the development of decompensated DCMP, congestive heart failure occurs, resulting in characteristic symptoms. Sometimes clinical signs appear after acute respiratory viral infections, pneumonia:
- pain in the region of the heart by the type of angina pectoris;
- shortness of breath while running, walking, after any physical exertion;
- with time – shortness of breath at rest;
- noisy breathing;
- attacks of cardiac asthma, pulmonary edema, which mainly occur at night (cough, severe shortness of breath, allocation of foamy sputum with blood, asphyxiation in a horizontal position);
- gurgling wheezing in the lungs;
- cyanosis of the nail plate, ears, nose, nasolabial triangle;
- during attacks – increased cyanosis and its spread throughout the skin and mucous membranes;
- cooling hands and feet;
- swelling of the legs, worse in the evening, at first – passing as you rest;
- pain in the right hypochondrium, severity, which are associated with overfilling of the liver with blood;
- puffiness of face;
- swelling of the veins of the neck;
- dropsy of the abdomen – ascites, which is inherent in the late stages of congestive heart failure;
- decreased urination, a decrease in portions of urine am >
In the later stages of the pathology, all the described problems arise, as well as changes in the brain. These include distraction, insomnia, mood swings, changes in memory and attention, and other disorders.
Characteristic cardiac arrhythmias also appear – paroxysms of the heartbeat, short-term interruptions in the activity of the heart, syncope, and dizziness.
Often there is extrasystole, blockade of the legs of the bundle of His, as well as a formidable complication – atrial fibrillation, during which the patient needs emergency medical attention.
In general, the course of the disease develops differently in different patients. It can be rapidly progressing, recurring, slowly progressing. If the pathology develops rapidly, then the symptoms of heart failure appear within 1-1,5 years. However, slow progression of dilated cardiomyopathy is more likely.
Myocardial damage, in which the ventricular cavities expand and their contractility decreases, is called dilated cardiomyopathy. It is manifested by heart failure, clogging of blood vessels by blood clots, arrhythmia. Relates to severe heart disease, transplantation may be required.
Cardiomyopathy is a group of heart diseases in which there are no signs of an inflammatory, tumor, or ischemic process. They are manifested by an increase in heart size, arrhythmia and progressive insufficiency of cardiac activity. These types of pathology are distinguished:
- dilated or congestive cardiomyopathy – the heart is enlarged;
- with myocardial hypertrophy – thickened walls;
- restrictive – the myocardium is dense and weakly stretched during the period of blood flow;
- arrhythmogenic – accompanied by various rhythm disturbances.
The first description of the pathological expansion of the heart in a previously healthy young peasant belongs to the Russian scientist S.S. Abramov.
He watched the course of the disease, which in four months from the onset of the initial signs of heart failure led to death.
Despite the fact that the disease has been known since 1897, scientists are discussing around it, since the very concept of “cardiomyopathy” means that the exact mechanism and causes of its development have not been established.
Cardiac disease treatment
It is very important to consult a doctor at an early stage of the disease, when diagnosis is possible according to the primary symptoms. In this case, the prognosis will not immediately become favorable, but the health risk will be significantly reduced. In fact, the patient will increase his chances of fighting a disease that is difficult to treat with standard treatment.
The basic limitations before treatment for patients with dilated cardiomyopathy include:
- Exclusion of physical activity;
- a complete ban on the consumption of salt;
- bed rest is desirable depending on the course of the disease.
Drug therapy is considered effective. According to statistics, for 80% of patients, drugs can be obtained that have a positive effect on the course of the disease.
List of commonly used drugs:
The three above drugs are included in the group of inhibitors. With pronounced violations with the rhythm of the heart, special drugs are used adrenoblockers. The most popular remedy is bisoprolol. It is possible that the doctor will also prescribe medications aimed at reducing blood flow to the region of the right heart muscle.
Each disease is individual, therefore it is very important not to self-medicate in such a difficult situation. Most often, doctors prescribe a specific treatment for DCMP (dilated cardiomyopathy), based on the individual characteristics of the body. In most cases, blood thinners are additionally prescribed. In particular, simple aspirin or acekardol.
To get rid of the symptoms of shortness of breath in the uncomplicated course of the disease, doctors recommend special nitrates in the form of a spray. Often these patients help out the drug Nitromin, sold in the pharmacy in the form of an aerosol.
Symptomatology of the disease
The disease often occurs in people at a young or middle age. The onset is usually gradual, with the exception of cases of acute myocarditis. Symptoms depend on which particular ventricle is affected. Left ventricular dysfunction provokes shortness of breath in patients on the background of physical activity along with fatigue due to increased diastolic pressure and low cardiac output.
Insufficiency of the right ventricle leads to the appearance of peripheral edema and swelling of veins in the neck. For isolated lesions, the development of atrial arrhythmia and the onset of sudden death due to malignant ventricular tachyarrhythmia are typical. About twenty-five percent of all patients with this diagnosis report the presence of atypical chest pain. Signs of dilated cardiomyopathy can be difficult to recognize.
In the early stages, only certain symptoms of heart failure are determined. Against the background of progression of left ventricular failure, shortness of breath occurs along with asthma attacks, rapid fatigue and muscle weakness. In the presence of cardiac auscultation, tachycardia is detected. In fifty percent of cases, pathology is complicated by the development of ventricular arrhythmias.
Signs of right ventricular failure are the appearance of swelling of the legs, heaviness in the right hypochondrium, an increase in the liver and abdomen. Thus, symptoms of dilated cardiomyopathy range from mild symptoms to severe heart failure.
If standard methods fail to achieve disease progression, secondary dilated cardiomyopathy occurs and the threat to life continues to exist, then surgical intervention is prescribed. The decision on heart surgery is usually made not by a single doctor, but by a special consultation consisting of the best specialists who take responsibility for the patient’s life. In total, there are three types of surgical intervention for this disease:
- implantation of a defibrillator in the heart;
- removal of excess tissue in the left ventricle;
- heart transplantation.
Heart transplant surgery
Doctors until the last will try to avoid surgery, but the decision will be made in any case, depending on the ratio of the risks of surgery and sudden death. That is, in cases where the disease threatens death in a short time – the operation remains the only hope to prolong life, although it may be the last for the patient.
Defibrillator implantation is necessary when life-threatening symptoms of arrhythmia occur. If the situation is successful, after a surgical intervention in a patient, the heart will work in normal mode. If the operation was performed correctly and no complications occurred, then in uncomplicated patients, the percentage of survival in a ten-year period is significantly increased.
Pacemaker implantation is prescribed in cases of intraventricular conduction disturbance. In addition, it is possible to implement this treatment method when uncoupling synchronous contractions in the atria and ventricles. The operation helps to get rid of such symptoms, but the risks are quite large.
Removal of excess tissue in the left ventricle in medical terminology is called myotomy. The bottom line is that part of the tissue interferes with the outflow of blood. After surgery, this problem disappears, reducing the risk of cardiac arrest.
Patients at risk of developing DCMP are recommended to choose professions that are not associated with excessive workload. Great sport is also contraindicated. If dilated cardiomyopathy is still detected, the main task is to prevent the development of heart failure. For the prevention of thromboembolic complications, continuous use of antiplatelet agents (Trental, Curantil) and anticoagulants (Heparin subcutaneously) is necessary.
In the absence of treatment and the natural course of the pathology, the prognosis is poor. Gradually, the heart completely stops performing the pumping function, which leads to exhaustion, degeneration of all organs and death. With drug therapy for DCMP, the prognosis for life is favorable – five-year survival is 60–80%. If a heart transplant was performed, the ten-year survival rate after surgery is 70–80%.
The labor prognosis depends on the stage of circulatory disorders. At the first stage of heart failure, the patient can work, but he is not allowed on business trips, night shifts, or heavy physical labor. To refuse such work, the employer is provided with an MSEC decision upon receipt of a disability group III (working) or a certificate from the attending physician. In the presence of IIA and above the stage of the disease, disability group II is determined.
Patients who are at risk of developing this pathology should in every way avoid professional sports, and, in addition, the choice of professions that are associated with overload. It is worth mentioning that the risk group includes people whose relatives include people with severe heart failure at a young age.
If dilated cardiomyopathy is detected in patients, the main task will be to prevent the progression of heart failure. We will name the main directions for assessing risk factors:
- Conducting a survey.
- Performing psychological testing to determine the level of anxiety.
- Health Assessment. In this case, the functional state of the alleged patients and the clinical manifestations of a possible pathology are analyzed.
- Monitoring risks that affect health.
- Assessing the effectiveness of preventive interventions and treatment. At the same time, healing methods are controlled along with the implementation of medical prescriptions and recommendations. The motivation of patients, their training in the basic techniques of healing are also monitored, comparative characteristics are carried out.
As for the recommendations of cardiologists regarding the prevention of dilated cardiomyopathy, they primarily include medical and genetic consultations in the presence of family cases of the disease. Equally important is the active treatment of a particular respiratory infection. It is necessary to exclude the use of alcohol. A balanced diet is especially important for such people, which will ensure a sufficient intake of minerals with vitamins in the body.
Thus, dilated cardiomyopathy is a myocardial lesion, which is characterized by expansion of the cavity of the left ventricle or both at once. In addition, this disease is accompanied by a violation of the contractile functions of the heart. Dilated cardiomyopathy may manifest as signs of congestive heart failure, thromboembolic syndrome, and rhythm disturbances.
Diagnosis of pathology is based on data from the overall clinical picture, and, in addition, it is repelled by objective examinations, electrocardiograms, phonocardiography, echocardiography and radiography. In addition, as part of the diagnosis, doctors additionally carry out scintigraphy, magnetic resonance imaging and myocardial biopsy.
The treatment of the disease is carried out mainly by inhibitors and adrenoblockers. Diuretics, nitrates, anticoagulants and antiplatelet agents are often used. Due to the danger to life, patients at risk require regular monitoring by a cardiologist, observing all necessary preventive measures. Unfortunately, sudden death with dilated cardiomyopathy is not uncommon.
Life expectancy after the onset of symptoms of DCMP varies from 4 to 7 years. The patient may die from unsynchronized contractions of the ventricles, prolonged circulatory failure, pulmonary thromboembolism. Clinical recommendations for the prevention of dilated cardiomyopathy include medical and genetic counseling (when the disease is hereditary), treatment of respiratory infections, cessation of alcohol consumption, nutritional balance, control of an adequate level of vitamins and minerals.
Features of food
Nutrition for dilated cardiomyopathy should be, first of all, balanced, include all the necessary vitamins and minerals in sufficient quantities. Doctors recommend that salty foods, rich broths, soups with legumes, sugary, fatty meat and fish, smoked foods, canned foods, processed meat (sausages and the like), fatty dairy products, fast food, strong drinks (alcohol, strong drinks) be excluded from consumption. tea or coffee), soda, mushrooms, cabbage, radish, green peas, various dressings and sauces, too spicy dishes, convenience foods.
It is advisable to eat steamed dishes without processing, without strong spices and salt, low-fat foods (including dairy products, meat, fish), durum products from durum wheat, fruits, vegetables, freshly squeezed juices. It is important to remember that all foods consumed in food must be of high quality so as not to cause digestive problems. With such problems, there is an additional burden on the heart.
Lifestyle for patients with cardiomyopathy
Types of pathology
Cardiomyopathy is a cardiac pathology that has a classification. Depending on the reason that triggered the process of changing myocardial tissue, its primary and secondary forms are distinguished. The disease is divided into several types, the determining factor allowing it to be classified is one of the 4 main types of damage to the heart muscle:
- dilated cardiomyopathy, in which there is an expansion of the heart chambers, a violation of the contractile function of the heart;
- hypertrophic cardiomyopathy – a characteristic change in the walls of the left heart ventricle, their thickening, with its development, the ventricular cavity does not expand;
- restrictive cardiomyopathy – the walls of the cardiac ventricles practically lose their ability to stretch, it is difficult to get blood into the left heart chamber, the atria experience an increased load;
- arrhythmogenic right ventricular cardiomyopathy – rarely diagnosed, occurs due to replacement of myocardial cells with fibrous or adipose tissue, accompanied by a change in the rhythm of ventricular contractions.
Specialists conducting studies on the nature of cardiomyopathy cannot currently approve a complete, exhaustive list of causes of pathological changes in heart muscle tissue. The most likely are:
- genetic disorders in which cardiomyocyte cells are not formed correctly, which leads to a defect in the muscle fibers of the heart and their malfunctioning;
- intoxication of body tissues that occurs when exposed to pesticides, alcoholic beverages, drugs, drugs (in most cases, they are antitumor drugs);
- infection with viruses, the progression of diseases caused by them (herpes, flu, Coxsackie virus, cytomegalovirus);
- a change in hormonal balance in the body;
- reduced immune defense;
- coronary and hypertensive heart disease;
- autoimmune pathologies developing in the patient;
- disturbances associated with the balance of electrolytes;
- myocardial fibrosis;
- neuromuscular diseases;
- accumulation diseases.
Depending on which type of cardiomyopathy develops in the patient, the manifestation of symptoms will have some features.
A dilated form of pathology is accompanied by signs:
- regular increase in blood pressure values;
- the patient experiences a breakdown, is very tired even with minor physical activity;
- movements are accompanied by severe shortness of breath;
- the skin becomes pale;
- fingertips become cyanotic;
- lower limbs noticeably swell.
Such symptoms occur and persist due to an increase in heart failure in the patient – the organ chambers expand, while the ability of the muscles to contract is lost. This condition becomes deadly, requires regular treatment.
The doctor may suspect the development of hypertrophic cardiomyopathy if the patient has symptoms associated with the gradual progression of heart failure:
- heart rhythm disorder;
- persistent pallor of the skin;
- the person notes that he has a constant weakness;
- shortness of breath is observed;
- the presence of chest pain;
- impaired consciousness may be observed.
If the patient ignores the signs, does not undergo diagnostic tests and does not receive quality treatment, the probability of his sudden death is high.
Another form of pathology is restrictive, accompanied by functional disorders:
- accompanying any physical action with severe shortness of breath;
- the appearance of edema.
Arrhythmogenic cardiomyopathy can be suspected in a patient if he experiences cardiac arrhythmias, often this is a significant increase in heart rate with increased physical activity.
Symptoms – pain in the sternum and behind it, severe fatigue, headache, shortness of breath, coughing at night, swelling, heaviness in the legs can cause a suspicion of the development of cardiomyopathy. At the initial examination of the patient, the doctor:
- reveals signs accompanying heart failure;
- draws attention to the presence of a bluish tint of the skin, an increase in the size of the veins located in the neck;
- listens to a heart tone with a stethoscope;
- conducts palpation and percussion of the chest and heart.
To confirm the diagnosis, the patient needs a comprehensive examination of the body. It is carried out using instrumental diagnostics:
- electrocardiography – as a result of the study, the doctor receives data on the presence of hypertrophy of the walls of the ventricles of the heart, its atria;
- daily ECG monitoring;
- ultrasound examination using ECHO-cardiography with duplex scanning, which allows you to assess the state of the organ, especially blood flow;
- X-ray examination of the heart with angiography (using X-ray equipment and a contrast agent with which the heart arteries are filled) in which the doctor sees a reliable picture that allows you to evaluate the size of the heart, the state of the vessels, blood flow;
- magnetic resonance and computed tomography – a highly informative method is used to assess the condition and identify pathological changes in the heart, allowing you to see the features of its structure;
- heart tissue biopsy – the study allows you to accurately determine the type and degree of damage to the heart tissue.
An integrated approach involves conducting several studies at once to identify signs of cardiomyopathy of the heart. The choice of a specific method depends on the availability of equipment in the clinic, the availability of a queue for diagnostic behavior, since in many cases operational information is required to confirm the diagnosis for the patient.
With heart failure, cardiomyopathy is a condition that requires observation in a medical institution, the appointment of quality treatment. Based on the fact that cardiomyopathy often has an unknown etiology, they approach the therapy comprehensively. The main methods of combating pathology after confirming the diagnosis are:
- drug treatment;
- surgical intervention;
- the patient’s transition to a special diet, the exclusion from his life of strong loads – physical and emotional.
The choice of drug treatment depends on the type of cardiomyopathy diagnosed in the patient, the characteristics of his condition. For therapy, it is prescribed:
- ACE inhibitors – lifelong use of drugs of this group is necessary;
- diuretics to reduce swelling in the tissues, lungs;
- beta-blockers that help regulate heart rate;
- nitrates to lower blood pressure, reduce the load on the heart and its oxygen demand;
- cardiac glycosides in order to regulate the contractility of muscle tissue;
- funds and vitamins that improve the nutrition of heart cells;
- anticoagulants (when detecting increased blood clotting, predisposition to blood clots).
If drug treatment of cardiomyopathy is ineffective, the patient’s condition is steadily worsening, doctors decide on surgical treatment. Applicable methods:
- ventricular septal myectomy;
- 2-chamber pacemaker;
- heart transplant from a donor.
The subsequent life of the patient should take place in a special mode. In a medical institution, he is recommended to be responsible for physical activity, to exclude:
- heavy and moderate physical labor;
- intense sports activities;
- nerve surge.
If the patient had bad habits before making the diagnosis – he smoked or regularly drank alcohol, refusing them can significantly improve the prognosis. Diet should be reviewed. A healthy menu for cardiomyopathy involves:
- the use of dietary meat and fish;
- the predominance of fruits and vegetables on the menu;
- rejection of salt and fatty foods.
With confirmation of cardiomyopathy, the prognosis often depends on how quickly the patient turned for medical help and began treatment. Medical statistics have data on the five-year survival of patients with the specified diagnosis:
- with a hypertrophic form of pathology – from 60% to 70%;
- less than 40% with restrictive and dilated forms;
- after heart transplant surgery, the life expectancy is more than 10 years for 30-50% of patients.
Cardiomyopathy is a dangerous pathology that requires prompt medical attention. Ignoring the symptoms often leads to an unexpected death.
- completely abandon bad habits (smoking, alcohol, drugs);
- reduce excess weight;
- establish proper nutrition;
- limit sweets and foods not recommended for use in the diet;
- limit salt;
- the mode of operation should not exhaust the body;
- excessive physical activity is contraindicated;
- a psychological attitude is needed to win the fight against the disease.
Proper nutrition is the key to health
Proper nutrition in most cases involves small portions, but often. Doctors usually recommend eating six times a day with a similar diagnosis. An individual diet is required for each case, but general recommendations are still present.
In addition, foods rich in selenium and zinc will be beneficial. Here, doctors are likely to advise adding cereals, buckwheat, eggs, lard and porcini mushrooms to the diet.
Pay attention to the operating mode. In general, it is recommended to carry out labor activities as part of a shorter working day. If this is not possible, then it is not allowed to violate the sleep and rest regimen. With cardiomyopathy of any kind, it is important to sleep at night, otherwise all efforts to combat the disease will go down the drain.
Of particular importance is the psychological attitude to combat dilated cardiomyopathy. It is important to understand that any of the most successful tactics for treating a disease will not bring the desired result if a person does not believe in a positive outcome. Survival statistics, of course, are not the most favorable, but there are a lot of people with a similar diagnosis all over the world who lead a decent lifestyle at any age.
This is not to say that there is a special method that can reduce the likelihood of developing dilated cardiomyopathy to zero. If the family has a genetic predisposition, then, of course, it is necessary to undergo an annual cardiological examination.
Often, those who have cases of illness among relatives are advised to give up professional sports and are not advised to choose a profession where they have to deal with increased physical stress on the body.
The most basic preventive measures, like any other disease, in the case of cardiomyopathies of all types do not differ. It is necessary to completely abandon bad habits, observe sleep and rest, receive a healthy and balanced diet.
Dilated cardiomyopathy with the achievements of modern medicine is not a sentence. Of course, this is a very unpleasant diagnosis, but timely treatment of the disease can significantly reduce the risk of sudden death. The main thing is to seek medical help at the first unpleasant symptoms from the heart.
However, even in the most terrible situations, it is possible to extend life due to competent surgical intervention. Five-year survival of patients diagnosed with dilated cardiomyopathy averages 80 percent. If you follow all the instructions of a qualified attending physician, lead the right lifestyle and have the necessary psychological attitude, it is quite possible to maintain a decent quality of life.
Features of food
Dilated cardiomyopathy is a myocardial disease, the development of which occurs from the left parts of the heart. This leads to stretching and thinning of the ventricle, so it cannot pump enough blood.
- At first, the problem does not manifest itself, but it poses a serious health hazard, as it causes heart failure, arrhythmias, thrombosis, or sudden death.
- Pathology affects people of any age, but is more common from 20 to 60 years.
In most cases, the causes of the development of the pathological process cannot be determined, then it is considered idiopathic. But the disease can also occur under the influence of various factors:
- In the presence of a genetic predisposition.
- In case of congenital heart defects.
- As a result of the penetration of bacteria, viruses, fungi and parasites into the body.
- If poisoning has occurred with lead, mercury, cobalt and other toxic substances.
- When drinking alcohol and drugs.
- With atherosclerotic changes in the vessels.
- Under the influence of constantly increased pressure.
- In violation of metabolic processes like diabetes.
- As a complication at the end of pregnancy.
- If the heart muscle was damaged during a heart attack.
- With diseases of the thyroid gland.
- If an insufficient amount of vitamin substances and minerals enters the body.
- With autoimmune diseases, including systemic lupus erythematosus.
- As a result of neuromuscular diseases.
- Under the influence of the human immunodeficiency virus.
The development of the pathological process is slow. At first, the patient does not feel any discomfort. In rare cases, a subacute course is observed, which is associated with acute respiratory viral infections or pneumonia.
With this disease:
- A man gets tired quickly.
- There is shortness of breath, which is associated with a violation of blood flow in the pulmonary circulation. With it, it is difficult for a person to breathe in a supine position, so he constantly has to sit or stand.
- Concerned bouts of dry cough.
- Symptoms of cardiac asthma appear.
- There are painful sensations in the heart during physical activity.
- Due to the fact that blood begins to stagnate in a large circle of blood circulation, a feeling of heaviness appears in the liver, legs swell, flu />
- Gradually, the rhythm of the heart and conduction are disrupted, which is accompanied by paroxysms of the heartbeat and interruptions in the work of the organ, periodically there is a loss of consciousness.
- With dilated cardiomyopathy, a clot of arteries with a thrombus often occurs, which can cause the death of the patient.
- The likelihood of embolism increases if a person suffers from atrial fibrillation.
- Pathology can develop quickly or slowly, periods of exacerbations are replaced by remissions.
From the appearance of the first signs of the disease, it takes about 1,5 years to the onset of the thermal stage. But most often, the disease progresses slowly.
Dilated cardiomyopathy requires careful diagnosis to confirm heart problems.
First, they examine the patient, listen to the heart, and collect an anamnesis of family and life. A number of examinations are also selected:
- To determine whether there are inflammatory processes in the body, hormonal disorders, toxic substances, a blood test is performed.
- A chest x-ray is performed to detect structural changes in the heart and the presence of fluid in the lungs.
- The electrical activity of the heart is evaluated using an electrocardiogram. Holter daily monitoring may be prescribed, during which the patient wears a portable device for several days that records the work of the heart.
- An ultrasound scan of the heart is performed to confirm ventricular enlargement. During the procedure, an image of the organ is obtained and its structure and functioning are studied.
- They resort to stress tests to determine how the heart carries loads. In this case, the patient should engage in a treadmill or exercise bike. Before this, electrodes are attached to it, which fix the heart rate and rhythm. These tests determine the severity of dilated cardiomyopathy. In addition to performing exercises, they can give a medicine that simulates increased loads.
- To more accurately determine how large the heart is and how well the cameras function, they can perform computed tomography or magnetic resonance imaging.
- Catheterization is performed to evaluate the pressure inside the heart and determine the level of blood expulsion from the chambers. This is an invasive procedure. It is introduced through a vessel on the arm or neck and carried to the heart. The catheter may contain a contrast agent that will stain the arteries and examine them under the influence of x-rays.
If there are difficulties in diagnosing and determining the cause of cardiomyopathy, the patient and his immediate family are sent for a genetic study to identify a hereditary predisposition to the problem.
Treatment of dilated cardiomyopathy is prescribed to eliminate increased blood clotting, symptoms of heart failure, and rhythm disturbances.
A person with such a diagnosis needs to observe bed rest, drink less fluid and eat less salt.
Prescribe medications. In the presence of heart failure, they resort to:
- angiotensin converting enzyme inhibitors;
- diuretic drugs.
If the heart rhythm is broken, then you can not do without beta-blockers and cardiac glucosides. You should also take medications to dilate blood vessels, prolonged nitrates, they will help reduce blood flow to the right side of the body.
To prevent blood clots due to increased blood density, anticoagulants are used. To do this, use heparin, which is injected under the skin. In addition to them, antiplatelet agents are prescribed in the form of Acetylsalicylic acid.
Also, if dilated cardiomyopathy is present, treatment may include surgical procedures. At severe stages of the development of the disease and with serious violations in the work of the heart, they may resort to transplantation of a healthy organ. After surgery, about 75% of patients survive.
If dilated cardiomyopathy has occurred, clinical recommendations are important to follow in order to avoid the development of complications. The patient must follow a diet, refuse fatty and fried, reduce the level of physical activity, avoid stress, regularly visit a doctor.
Half of the cases end in the death of patients. The reasons for this lie in severe violations in the work of the heart, the development of fibrillation, thromboembolism. All other patients die more slowly during the development of heart failure.
With this disease:
- conduction of the heart is disturbed;
- blood clots form in the vessels, which can come off and clog the lumen;
- in a chronic form, heart failure occurs, due to which all organs and tissues suffer from insufficient blood supply;
- the rhythm of the contractions of the heart is disturbed.
According to statistics, a fatal outcome occurs within five years in most patients. Gradually, the wall of the heart becomes thin, because of this, it is difficult for the body to function, which reduces the life expectancy of a person.
After heart transplantation, the prognosis improves significantly. Most people after the procedure live for about ten years. You can extend life slightly and reduce the likelihood of complications if you follow the doctor’s instructions.
Dilated cardiomyopathy is a disease that occurs in childhood. The likelihood of developing a problem increases if there is a hereditary predisposition to the problem. The genetic form of the disease begins to appear within the first three years.
Young children usually suffer from idiopathic cardiomyopathy, the cause of which cannot be detected.
In older children, the disease occurs under the influence of negative factors. The danger of the problem is that it gradually leads to heart failure, thrombosis. Most children do not live to adulthood. Death often occurs with a congenital form of the disease during the first two months of life.
In the presence of pathology in children, symptomatic therapy is usually used. If there are other diseases, then you need to get rid of them.
Therapeutic measures are aimed at preventing the development of heart failure and thromboembolism.
To do this, use inhibitors, drugs to reduce blood pressure and other drugs. The dosage should be selected by the doctor, taking into account the age and weight of the child, the characteristics of his body.
There are no clear recommendations that would help to avoid the development of the problem. You can reduce the risk of violations if you abandon bad habits, eat right, make up a normal regime of physical activity.
If you timely detect the problem and conduct treatment, then you can reduce the rate of development of complications and increase life expectancy.