Chapter 26
Dilated Cardiomyopathy
1. What is the definition of dilated cardiomyopathy?
4. What kind of diagnostic studies should be carried out for DCM?
Multigated radionuclide angiocardiography (MUGA) may be used to assess LV systolic function in those with poor echocardiographic windows. Compared with echo assessment of LVEF, MUGA may have less interobserver and intertest variability. Thallium-201 myocardial scintigraphy is not a reliable technique for differentiating patients with ischemic cardiomyopathy (ICM) from those with DCM, as patients with DCM may have both reversible and fixed perfusion abnormalities related to the presence of myocardial fibrosis, although a completely normal scan (without reversible or fixed defects) would favor the diagnosis of NICM.
Endomyocardial biopsy may be performed if and only if a specific diagnosis is suspected in which specific therapy may be efficacious upon establishment of diagnosis (see Chapter 23 on endomyocardial biopsy).
5. What is the natural history of DCM?
6. What are the prognostic features of DCM?
7. What are the common causes of DCM?
8. What are the features of alcohol-induced cardiomyopathy?
9. What are the features of cocaine-induced cardiomyopathy?