Dilated Cardiomyopathy: Pathogenesis and Treatment

Abstract

Dilated cardiomyopathy refers to a serious form of heart disease characterized by a primary abnormality of the cardiac myocardium. In this form of heart disease, the myocardium becomes dysfunctional and leads to dilatation of the cardiac chambers (most characteristically, the left ventricle). By definition, coronary atherosclerosis, valvular heart disease, congenital heart disease, and hypertensive heart disease have been excluded. Based on a thorough evaluation employing clinical symptoms and signs and further evaluation by EKG, chest x-ray. echocardiography, radionuclide gated blood pool scan, and cardiac catheterization, other causes of a dilated cardiomyopathic ventricle have been excluded. The poor systolic myocardial dysfunction must result from weakness of the myocardium itself. Although some authors choose to designate heart failure due to coronary disease as a form of “dilated cardiomyopathy”, most investigators (including myself) reserve the term dilated cardiomyopathy for primary myocardial dysfunction, after excluding the other causes of heart disease listed above.