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Dilatative Kardiomyopathie

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Zusammenfassung

Die dilatative Kardiomyopathie (DCM) ist eine heterogene Gruppe kardialer Erkrankungen, die durch eine Einschränkung der systolischen linksventrikulären Funktion gekennzeichnet ist und in der Regel mit einer Erweiterung der Herzbinnenräume einhergeht. Etwa ein Drittel aller idiopathischen DCM-Formen ist genetisch bedingt, weshalb eine sorgfältige Erhebung der Familienanamnese obligater Bestandteil der Diagnostik ist. Der klinische Verlauf kann sehr variabel sein, Leitsymptome sind belastungsabhängige Dyspnoe sowie reduzierte Belastbarkeit. In der körperlichen Untersuchung können zudem periphere Ödeme, Hepatomegalie, Pleuraergüsse, grobblasige Rasselgeräusche, Jugularvenenstauung, Blässe, Kachexie und ein dritter Herzton gefunden werden. Die primäre Dokumentation einer Dilatation und Reduktion der systolischen Pumpfunktion erfolgt regelhaft mittels transthorakaler Echokardiographie und Magnetresonanztomographie. Als wichtigste Differenzialdiagnose gilt die ischämische Kardiomyopathie aufgrund einer koronaren Herzerkrankung. Die Behandlung der idiopathischen sowie der familiären DCM orientiert sich an den Leitlinien zur Behandlung der Herzinsuffizienz. Ziele der medikamentösen und interventionellen Therapie sind die Milderung der Symptome, Vorbeugung eines Krankheitsprogress sowie damit assoziierter Endorganschäden zur Reduktion von kardialen Dekompensationen, Krankenhausaufenthalten und Verbesserung der Prognose.

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Correspondence to Regina Pribe-Wolferts .

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1 Electronic Supplementary Material

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Kardialer Phänotyp der DCM in der transthorakalen Echokardiographie und Magnetresonanztomographie. a Echokardiographie : apikaler Vierkammerblick und b Zweikammerblick einer schweren DCM mit deutlich dilatiertem linken Ventrikel und global hochgradig eingeschränkter Pumpfunktion. c Durch eine Anulusdilatation hervorgerufene sekundäre Mitralklappeninsuffzienz.d Magnetresonanztomographie nach Kontastmittelgabe: Langachsenorientierung und e Kurzachsenorientierung mit streifenförmigen intramuralem „Late Gadolinium Enhancement“ (AVI 12631 kb)

Video 1B

Video 1C

Video 1D

Video 1E

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Pribe-Wolferts, R., Ehlermann, P., Meder, B., Katus, H.A. (2015). Dilatative Kardiomyopathie. In: Lehnert, H., et al. DGIM Innere Medizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54676-1_185-2

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  • DOI: https://doi.org/10.1007/978-3-642-54676-1_185-2

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  • Online ISBN: 978-3-642-54676-1

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Chapter history

  1. Latest

    Dilatative Kardiomyopathie
    Published:
    01 June 2016

    DOI: https://doi.org/10.1007/978-3-642-54676-1_185-2

  2. Original

    Dilatative Kardiomyopathie
    Published:
    10 March 2015

    DOI: https://doi.org/10.1007/978-3-642-54676-1_185-1