Dilated Cardiomyopathy

Dilated cardiomyopathy is a heart muscle disorder, where the heart muscles are abnormally weak. This results in an enlarged heart ('dilatation') with poor heart pumping function.

Common causes for dilated cardiomyopathy include:

• Gene mutation/ inherited
• Previous virus infection of the heart
• Previous cancer treatment (chemotherapy)
• Chronic alcoholism

• Shortness of breath (on exertion or during rest)
• Worsening exercise tolerance
• Difficulty in breath when lying flat
• Waking up breathless at night
• Chronic fatigue
• Swelling of ankles/ legs/ abdomen (fluid retention)
• Unexplained fainting spells

Dilated cardiomyopathy is diagnosed by cardiologists, by integrating various clinical information, including:

• Patient symptoms
• Clinical examination
  • Look for presence of fluid retention
• Electrocardiogram ('ECG')
  • Electrical tracing of the heart, looking for heart rhythm abnormalities, as well as signs of underlying structural heart abnormalities
• Echocardiogram
  • Ultrasound examination which can allow doctors to evaluate heart structure and function
• Cardiovascular magnetic resonance imaging ('Cardiac MRI')
  • Specialised scan looking specifically at the heart muscles

Most patients with dilated cardiomyopathy will require only medication treatment to stablise the condition and prevent worsening of symptoms and heart function. In patients with very poor heart pumping function, a cardiac defibrillator can be implanted to reduce the risks of sudden cardiac death.

Patients with severe symptoms or with deteriorating heart functions, they might be evaluated suitability for mechanical heart pump implantation or heart transplantation.

Genetic Counselling

Since dilated cardiomyopathy is a potentially inheritable condition, a detailed family history will be obtained. Selected patients will be encouraged to undergo genetic counselling and genetic testing, to identify the culprit gene.

The Cardiomyopathy Clinic at the National University Heart Centre, Singapore (NUHCS) provides a comprehensive evaluation and treatment service for patients with dilated cardiomyopathy.

Panel A: Echocardiogram of a normal heart, with normal sized heart chambers

Panel B: Echocardiogram of a patient with dilated cardiomyopathy, showing abnormal enlargement/ dilatation of all chambers of the heart.