Dilated cardiomyopathy
- Lesion
In dilated cardiomyopathy the heart becomes large, baggy and weak. Genes, alcohol, infections, pregnancy and some drugs can cause it.
What it is
Dilated cardiomyopathy (DCM) is progressive dilation and systolic dysfunction of the ventricles, usually with some hypertrophy. A sizeable minority is genetic, most often truncating mutations in the giant sarcomere protein titin (TTN), and also lamin A/C (with conduction disease) and dystrophin (Duchenne and Becker). Acquired causes include alcohol, myocarditis, anthracyclines and other drugs, iron overload, peripartum cardiomyopathy and tachycardia. Takotsubo (stress) cardiomyopathy is a reversible ventricular dysfunction triggered by catecholamines.
Structure
- Gross: large globular heart, thin or normal-thickness walls, dilated cavities, often mural thrombi in the apex.
- Microscopy: myocyte hypertrophy with irregular nuclei, some stretched attenuated fibres, interstitial fibrosis; little inflammation.
Clinical notes
- Presents with slowly progressive heart failure, arrhythmias and embolism; transplant is an option at end stage.
- In Latin America, Chagas cardiomyopathy is an important cause of a dilated phenotype.
Test yourself
Think of the answer, then tap the question to see it.
Which gene is most often mutated in familial dilated cardiomyopathy?
TTN, encoding titin (truncating mutations).
What is the typical shape of the left ventricle in Takotsubo cardiomyopathy?
Apical ballooning with a narrow neck, like the octopus trap that gives it its name.
When does peripartum cardiomyopathy appear?
In late pregnancy or the months after delivery.
Elsewhere in DurgiPedia
Connections
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Dilated cardiomyopathy: MedlinePlus Medical Encyclopedia (MedlinePlus, US National Library of Medicine, 2025); Peripartum cardiomyopathy: MedlinePlus Medical Encyclopedia (MedlinePlus, US National Library of Medicine, 2025).
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Representative model, for educational purposes only.