Lviv clinical bulletin 2014, 1(5)-2(6): 54-57

https://doi.org/10.25040/lkv2014.01.054

Modern View on the Dilated Cardiomyopathy

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І. Yuzych

Danylo Halytsky Lviv National Medical University

Introduction. Dilated Cardiomyopathy (DCM) is a chronic disease caused by various conditions which lead to the ventricular dilatation, which decreases their contractile ability of the myocardium. DCM occurs more frequently in men than in women, and is the most common in the age 20-60 years. About one in three cases of congestive heart failure is due to the dilated cardiomyopathy. Symptoms of DCM can occur at any age and may include shortness of breath, swelling of the lower extremities and feeling of fatigue. This article contains a literature review concerning this disease.

Aim. To make an overview of modern literature on the issue of DCM.

Materials and methods. The content analysis, method of system and comparative analysis, the bibliosemantic method of studying the actual research in relation to the problem of DCM was used.

Results. Clinical feature of DCM – increasing heart failure severity refractory to the treatment. In the early stages of the disease, the clinical symptoms are quite small. Patients can only complain of weakness and moderate shortness of breath but do not attach importance to this. Laboratory indices in patients with DCM generally are not informative.

Echocardiography, which today is the most important method of the diagnosis of DCM helps to see the increasing of the heart chambers sizes, namely the increase of the end-diastolic sizes of the left and right ventricules, diffuse nature of the lesions, reducing of its contractility and in accordance with this the ejection fraction decreasing, relative mitral and tricuspid valves insufficiency signs. In this case the hypertrophy of the left ventricle walls may be missing, or its size is not commensurate with the sizes of dilatation. With the decrease of the contractile ability of the myocardium the likelihood of detecting the mural clots in heart chambers increases, and this can then become a source of thromboembolism.

Regardless of etiology, the treatment of DCM is symptomatic and is based on the correction and prevention of the major clinical manifestations and complications – congestive heart failure, rhythm disorders and thromboembolism.

Surgical treatment of DCM is used in case of the resistancy to intensive medical treatment of heart failure and provides heart transplantation followed by immunosuppressive treatment. If there is a risk of the patient’s life-threatening arrhythmia, it is advisable cardioverter defibrillator implantation.

Conclusions.  DCM is determined predominantly by the degree of congestive heart failure, the risk of sudden death increases with its increase. The main causes of death of patients are ventricular fibrillation, decompensation of congestive heart failure, thromboembolism. The diagnosis of the disease in the early stages allows the appointment of appropriate treatment, and, therefore, preventing the occurrence of fatal complications.

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