What are the stage symptoms of dilated cardiomyopathy?

As the name suggests, dilated cardiomyopathy causes the atria of the heart to expand, which can lead to gradual heart failure. The symptoms of dilated cardiomyopathy at various stages are quite obvious, such as arrhythmia, dyspnea and so on.

The disease can occur at any age, but is more common in middle-aged people. The onset is usually slow, and initial examination reveals an enlarged heart with compensatory cardiac function without any conscious discomfort. Symptoms develop gradually over a period of time, which can sometimes last more than 10 years. The main symptoms are congestive heart failure, among which shortness of breath and edema are the most common. Initially, shortness of breath occurs after labor or fatigue, and later shortness of breath also occurs during light activity or rest, or there are paroxysmal shortness of breath at night. Due to low cardiac output, patients often feel fatigued. Physical examination shows accelerated heart rate, apex beat shifted to the lower left, there may be a lifting beat, the boundary of cardiac dullness expanded to the left, the third or fourth sound can often be heard, and the heart rate is a gallop rhythm when fast. Due to the enlargement of the heart chamber, there may be a systolic blowing murmur caused by relative mitral or tricuspid regurgitation, which will be alleviated as heart function improves. Blood pressure is mostly normal, but in late-stage cases, blood pressure is low, pulse pressure is low, and diastolic pressure may be slightly elevated when heart failure occurs. The presence of pulse alternans suggests left heart failure. The pulse is often weak. In heart failure, there may be rales at the base of both pulses. In right heart failure, the liver enlarges and edema appears starting from the lower limbs. Pleural effusion and ascites are not uncommon in late-stage patients.

Various arrhythmias may occur as the first or main manifestation, and multiple arrhythmias may coexist to form a more complex heart rhythm, which may occur repeatedly and is sometimes very stubborn. High-degree atrioventricular block, ventricular fibrillation, sinoatrial block or pause can lead to Adams-Stokes syndrome, which is one of the causes of death. In addition, there may be embolism in the brain, kidneys, lungs, etc.

The three stages of dilated cardiomyopathy

The characteristics of dilated cardiomyopathy are obvious enlargement of the left ventricle (mostly) or right ventricle, accompanied by varying degrees of myocardial hypertrophy and decreased ventricular contractile function, with cardiac enlargement, heart failure, arrhythmia and embolism as basic features. It was previously called congestive cardiomyopathy. This disease is often accompanied by arrhythmia and has a high mortality rate.

The disease has a slow onset and can occur at any age, but is more common in people aged 30 to 50 years old. Hereditary DCM develops earlier. The course of DCM can be divided into three stages:

1. Asymptomatic period

Physical examination was normal, X-ray examination showed mild heart enlargement, electrocardiogram showed nonspecific changes, echocardiography measured left ventricular end-diastolic diameter of 5-6.5 cm, and ejection fraction between 40% and 50%.

2. Symptomatic Stage

The main symptoms are extreme fatigue, weakness, shortness of breath, palpitations, etc., early diastolic gallop rhythm, echocardiography measures the left ventricular end-diastolic diameter as 6.5~7.5cm, and the ejection fraction is between 20%~40%.