Kardiomiopatia rozstrzeniowa
Objawy

Kardiomiopatia rozstrzeniowa (DCM) charakteryzuje się powiększeniem i rozciągnięciem komór serca, zwłaszcza lewej komory, co prowadzi do upośledzenia kurczliwości i zmniejszenia frakcji wyrzutowej. Początkowo pacjenci mogą być bezobjawowi lub prezentować łagodne symptomy, takie jak atypowy ból w klatce piersiowej (około 25% przypadków), zmęczenie, duszność wysiłkową, obrzęki obwodowe, kołatanie serca czy zawroty głowy. Choroba przebiega przez stadia od A (czynniki ryzyka bez zmian strukturalnych) do D (ciężka niewydolność serca w spoczynku). Postępujący remodeling lewej komory obejmuje zwiększenie objętości końcowo-rozkurczowej i końcowo-skurczowej, ścieńczenie ściany oraz zmianę geometrii na sferyczną, co wiąże się z dalszym spadkiem frakcji wyrzutowej. Mechanizmy kompensacyjne, takie jak prawo Franka-Starlinga i aktywacja układu neurohormonalnego, początkowo maskują objawy, lecz z czasem przyczyniają się do progresji niewydolności serca.

  1. Objawy kardiomiopatii rozstrzeniowej
    1. Wczesne objawy kardiomiopatii rozstrzeniowej
    2. Typowe objawy kardiomiopatii rozstrzeniowej
    3. Objawy w zależności od zajętej części serca
  2. Rozwój i progresja choroby
    1. Stadia progresji kardiomiopatii rozstrzeniowej
    2. Mechanizmy progresji choroby
    3. Potencjalne powikłania
  3. Rokowanie w kardiomiopatii rozstrzeniowej
    1. Czynniki wpływające na rokowanie
    2. Wskaźniki prognostyczne
    3. Współczesne trendy w rokowaniu
    4. Niejednorodność rokowania
    5. Kolejne rozdziały

Objawy kardiomiopatii rozstrzeniowej

Kardiomiopatia rozstrzeniowa (DCM – Dilated Cardiomyopathy) to choroba mięśnia sercowego charakteryzująca się powiększeniem i rozciągnięciem (rozszerzeniem) komór serca, szczególnie lewej komory, co prowadzi do osłabienia kurczliwości i zmniejszenia zdolności serca do pompowania krwi. Objawy tej choroby mogą być zróżnicowane i często rozwijają się stopniowo, choć u niektórych pacjentów mogą pojawić się nagle12.

Wczesne objawy kardiomiopatii rozstrzeniowej

Na wczesnym etapie choroby wielu pacjentów może nie wykazywać żadnych objawów lub mieć objawy łagodne, łatwe do przeoczenia. Szacuje się, że około 25% wszystkich pacjentów z kardiomiopatią rozstrzeniową doświadcza atypowego bólu w klatce piersiowej3. We wczesnych stadiach DCM organizm uruchamia mechanizmy kompensacyjne, które mogą maskować objawy choroby – u niektórych pacjentów mogą one pozostać bezobjawowi nawet przy zaawansowanej dysfunkcji serca45.

Warto zauważyć, że choroba może rozwijać się podstępnie przez dłuższy czas, a pacjenci mogą przechodzić przez bezobjawową fazę dysfunkcji skurczowej lewej komory o różnym nasileniu, od łagodnej do ciężkiej, zanim rozwinie się jawna niewydolność serca6.

Typowe objawy kardiomiopatii rozstrzeniowej

Gdy kardiomiopatia rozstrzeniowa postępuje, pojawiają się bardziej wyraźne objawy, które często przypominają objawy niewydolności serca. Do najczęstszych objawów DCM należą789:

  • Zmęczenie i osłabienie – spowodowane zmniejszonym przepływem krwi i zmniejszoną dostawą tlenu do tkanek
  • Duszność (dyspnea) – występująca podczas wysiłku fizycznego lub w pozycji leżącej (orthopnea)
  • Obrzęki – najczęściej nóg, kostek, stóp lub brzucha (obrzęk w wyniku retencji płynów)
  • Zmniejszona tolerancja wysiłku – szybkie męczenie się podczas aktywności fizycznej
  • Kołatanie serca (palpitacje) – uczucie szybkiego, trzepoczącego lub mocnego bicia serca
  • Ból lub dyskomfort w klatce piersiowej – zwłaszcza podczas wysiłku
  • Zawroty głowy lub uczucie lekkości w głowie
  • Omdlenia – wynikające z zaburzeń rytmu serca lub niewystarczającego przepływu krwi do mózgu

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Inne objawy, które mogą wystąpić wraz z rozwojem choroby, to1213:

  • Kaszel – szczególnie w pozycji leżącej
  • Nocna duszność napadowa (paroxysmal nocturnal dyspnea) – budzenie się w nocy z uczuciem duszności
  • Niespodziewany przyrost masy ciała – związany z retencją płynów
  • Utrata apetytu
  • Nudności
  • Powiększenie obwodu brzucha – z powodu nagromadzenia płynu w jamie brzusznej (wodobrzusze)
  • Powiększone żyły szyjne

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Objawy w zależności od zajętej części serca

Objawy kardiomiopatii rozstrzeniowej mogą różnić się w zależności od tego, która część serca jest najbardziej dotknięta chorobą16:

  • Dysfunkcja lewej komory – powoduje duszność wysiłkową i zmęczenie z powodu podwyższonego ciśnienia rozkurczowego w lewej komorze i niskiego rzutu serca
  • Niewydolność prawej komory – prowadzi do obrzęków obwodowych i rozszerzenia żył szyjnych
  • Dominująca niewydolność prawej komory – występuje rzadziej, głównie u młodszych pacjentów, typowe są zaburzenia rytmu serca i nagła śmierć spowodowana złośliwymi tachyarytmiami komorowymi

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Rozwój i progresja choroby

Kardiomiopatia rozstrzeniowa jest zazwyczaj schorzeniem przewlekłym, które rozwija się stopniowo. Choroba może przebiegać różnie u poszczególnych pacjentów, a jej progresja może być powolna lub stosunkowo szybka1819.

Stadia progresji kardiomiopatii rozstrzeniowej

Kardiomiopatię rozstrzeniową i związaną z nią niewydolność serca można podzielić na stadia według nasilenia objawów2021:

  • Stadium A: Pacjent ma czynniki ryzyka DCM, ale nie ma objawów ani zmian strukturalnych w sercu
  • Stadium B: Pacjent nie ma objawów, ale występują zmiany strukturalne w sercu – powiększenie serca, dysfunkcja skurczowa, nieprawidłowości zastawek
  • Stadium C: Pacjent ma objawy niewydolności serca i ograniczenie aktywności fizycznej. Nawet łagodny wysiłek, jak chodzenie na krótkich dystansach, może prowadzić do duszności i zmęczenia
  • Stadium D: Ciężkie objawy niewydolności serca występujące nawet w spoczynku, pomimo optymalnego leczenia

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Wraz z postępem choroby, serce ulega przebudowie (remodelingowi). Proces ten obejmuje stopniowe zwiększanie się objętości końcowo-rozkurczowej i końcowo-skurczowej lewej komory, ścieńczenie ściany serca oraz zmianę geometrii komory na bardziej sferyczną, mniej wydłużoną. Ten proces zwykle wiąże się z ciągłym spadkiem frakcji wyrzutowej23.

Mechanizmy progresji choroby

Gdy kardiomiopatia rozstrzeniowa się rozwija, aktywowane są dwa mechanizmy kompensacyjne w odpowiedzi na upośledzoną kurczliwość miocytów i zmniejszoną objętość wyrzutową24:

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Te mechanizmy początkowo kompensują zmniejszoną pojemność minutową serca i utrzymują pacjentów z DCM w stanie bezobjawowym. Z czasem jednak mechanizmy te stają się szkodliwe – objętość wewnątrznaczyniowa staje się zbyt duża, a postępujące rozszerzenie komór prowadzi do objawów niewydolności serca26.

Potencjalne powikłania

Nieleczona lub postępująca kardiomiopatia rozstrzeniowa może prowadzić do szeregu poważnych powikłań2728:

  • Niewydolność serca – najczęstsze powikłanie DCM
  • Zaburzenia rytmu serca (arytmie) – przedsionkowe i komorowe
  • Zaburzenia przewodzenia
  • Powikłania zakrzepowo-zatorowe – w tym udar mózgu i zatorowość płucna
  • Nagła śmierć sercowa – może wystąpić na każdym etapie choroby, nawet jako pierwszy objaw
  • Problemy z zastawkami serca – zwłaszcza niedomykalność zastawek

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Ryzyko nagłej śmierci sercowej z powodu arytmii komorowych jest szczególnie wysokie, gdy występuje ciężkie upośledzenie funkcji skurczowej. Jednak niektóre genetyczne przyczyny DCM są związane z podwyższonym ryzykiem nagłej śmierci sercowej nawet wtedy, gdy funkcja skurczowa jest stosunkowo zachowana32.

Rokowanie w kardiomiopatii rozstrzeniowej

Rokowanie w kardiomiopatii rozstrzeniowej jest zróżnicowane i zależy od wielu czynników, takich jak przyczyna choroby, zaawansowanie zmian, wiek pacjenta oraz obecność chorób współistniejących33.

Czynniki wpływające na rokowanie

Na rokowanie w DCM wpływają między innymi3435:

  • Etiologia choroby – niektóre przyczyny DCM, jak alkoholowa kardiomiopatia czy kardiomiopatia tachyarytmiczna, mają lepsze rokowanie w przypadku odpowiedniego leczenia
  • Stopień zaawansowania niewydolności serca – gorsze rokowanie wiąże się z ciężką niewydolnością serca
  • Wiek pacjenta – wyższa śmiertelność jest związana z zaawansowanym wiekiem
  • Płeć – gorsze rokowanie ma płeć męska
  • Zachowana grubość ściany serca – rokowanie jest lepsze, jeśli kompensacyjny przerost zachowuje grubość ściany komory
  • Stopień rozszerzenia komór – rokowanie jest gorsze, jeśli ściany komór znacznie się ścieńczają, a komora ulega rozszerzeniu
  • Czas rozpoznania i rozpoczęcia leczenia – wczesne rozpoznanie i leczenie poprawiają rokowanie

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Wskaźniki prognostyczne

Niewydolność nerek i ciężka niewydolność serca są oznakami złego rokowania. Pacjenci, którzy mają objawy w spoczynku lub nie mogą wykonywać aktywności fizycznej, mają tendencję do najgorszego rokowania37.

Badanie Framingham Heart Study wykazało, że około 50% pacjentów z rozpoznaną zastoinową niewydolnością serca umiera w ciągu 5 lat. Pacjenci z ciężką niewydolnością serca mają ponad 50% roczną śmiertelność, podczas gdy pacjenci z łagodną niewydolnością serca mają znacznie lepsze rokowanie, szczególnie przy optymalnej terapii medycznej38.

Współczesne trendy w rokowaniu

W przeszłości rokowanie w DCM było uważane za bardzo niekorzystne, a choroba często postępowała do śmierci z powodu niewydolności serca lub transplantacji serca39. Jednak w ostatnich latach rokowanie dla pacjentów z kardiomiopatią rozstrzeniową poprawiło się dzięki dostępnym metodom leczenia oraz wczesnemu rozpoznaniu i leczeniu40.

Współcześnie, przy optymalnym farmakologicznym i niefarmakologicznym leczeniu, przeżycie wolne od śmierci lub transplantacji serca sięga 85% w ciągu 10 lat41. Obecnie ponad 80% pacjentów z tą chorobą żyje podczas wizyty kontrolnej po ośmiu latach i nie wymaga przeszczepu serca42.

Poprawione wyniki leczenia DCM są równoległe do wyższego wskaźnika odwrotnego remodelingu lewej komory (LVRR): w ostatnich latach szereg badań wykazał, że prawie 40% pacjentów doświadcza znaczącego LVRR, gdy są leczeni opartymi na dowodach metodami farmakologicznymi i urządzeniami43.

Badania z 2021 roku sugerują, że około 15% osób z DCM, które otrzymują właściwe leczenie, doświadcza powrotu do zdrowego rozmiaru i funkcji lewej komory, a liczba ta może wzrosnąć dzięki nowszym terapiom niewydolności serca44.

Niejednorodność rokowania

Pomimo postępu terapeutycznego, wyniki leczenia pacjentów z DCM często pozostają nieprzewidywalne, a poważne zdarzenia niepożądane mogą wystąpić w pierwszych miesiącach po diagnozie45.

Niektóre genetyczne przyczyny DCM są związane z bardziej agresywnym przebiegiem naturalnym niż inne. W tych bardziej agresywnych formach, powikłania sercowe (w tym arytmie komorowe, zaburzenia przewodzenia, ciężkie upośledzenie skurczowe i włóknienie mięśnia sercowego) występują wcześniej w naturalnym przebiegu choroby46.

Podsumowując, kardiomiopatia rozstrzeniowa to poważne schorzenie, które może się objawiać w różny sposób – od braku objawów do ciężkiej niewydolności serca i nagłej śmierci sercowej. Kluczowe znaczenie ma wczesne rozpoznanie i odpowiednie leczenie, które mogą znacząco poprawić rokowanie i jakość życia pacjentów z tą chorobą.

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  1. 14.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Dilated cardiomyopathy Information | Mount Sinai – New York
    https://www.mountsinai.org/health-library/diseases-conditions/dilated-cardiomyopathy
    Dilated cardiomyopathy is a condition in which the heart muscle becomes weakened and enlarged. As a result, the heart cannot pump enough blood to the rest of the body. […] Symptoms of heart failure are most common. They most often develop slowly over time. However, sometimes symptoms start very suddenly and may be severe. […] Common symptoms are: Chest pain or pressure (more likely with exercise), Cough, Fatigue, weakness, faintness, Irregular or rapid pulse, Loss of appetite, Shortness of breath with activity or after lying down (or being asleep) for a while, Swelling of feet and ankles. […] Chronic heart failure becomes worse over time. Many people who have heart failure will die from the condition. […] Heart failure is most often a chronic illness, which may get worse over time. Some people develop severe heart failure, in which medicines, other treatments, and surgery no longer help. Many people are at risk for deadly heart rhythms, and may need medicines or a defibrillator.
  • #2 Dilated Cardiomyopathy: Symptoms and Treatment
    https://my.clevelandclinic.org/health/diseases/16932-dilated-cardiomyopathy
    Many people with dilated cardiomyopathy dont have any symptoms, especially in the early stages. But as heart function worsens, you may notice symptoms more and more. […] Dilated cardiomyopathy symptoms may include: Chest pain, Cough and congestion, Dizziness or lightheadedness, Fainting, Fatigue (unusual tiredness), Palpitations or fluttering in your chest, Shortness of breath (dyspnea), Swelling in your belly, legs, ankles and feet (edema), Unexpected weight gain from fluid retention. […] Your prognosis depends on the cause and severity of the disease. With ongoing care, you may return to work and your usual daily activities. But you may have symptoms that get worse with time. Advanced dilated cardiomyopathy or complications can make you severely ill. You may need to stay in the hospital until symptoms improve.
  • #3 Dilated Cardiomyopathy – Cardiovascular Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/cardiovascular-disorders/cardiomyopathies/dilated-cardiomyopathy
    Dilated cardiomyopathy is myocardial dysfunction causing heart failure in which ventricular dilation and systolic dysfunction predominate. Symptoms include dyspnea, fatigue, and peripheral edema. […] Onset of dilated cardiomyopathy is usually gradual except in acute myocarditis, acute apical ballooning cardiomyopathy, and tachyarrhythmia-induced cardiomyopathy. About 25% of all patients with dilated cardiomyopathy have atypical chest pain. Other symptoms depend on which ventricle is affected. […] Left ventricular dysfunction causes exertional dyspnea and fatigue due to elevated left ventricular diastolic pressure and low cardiac output. […] Right ventricular failure causes peripheral edema and neck vein distention. Infrequently the right ventricle is predominantly affected in younger patients, and atrial arrhythmias and sudden death due to malignant ventricular tachyarrhythmias are typical.
  • #4 Dilated cardiomyopathy – Wikipedia
    https://en.wikipedia.org/wiki/Dilated_cardiomyopathy
    Dilated cardiomyopathy (DCM) is a condition in which the heart becomes enlarged and cannot pump blood effectively. Symptoms vary from none to feeling tired, leg swelling, and shortness of breath. It may also result in chest pain or fainting. Complications can include heart failure, heart valve disease, or an irregular heartbeat. […] Dilated cardiomyopathy develops insidiously, and may not initially cause symptoms significant enough to impact on quality of life. Nevertheless, many people experience significant symptoms. These might include shortness of breath, syncope (fainting), and angina, but only in the presence of ischemic heart disease. […] As DCM progresses, two compensatory mechanisms are activated in response to impaired myocyte contractility and reduced stroke volume: Frank-Starling law and neurohormonal feedback, via activation of the sympathetic nervous system and the renin-angiotensin system. These responses initially compensate for decreased cardiac output and maintain those with DCM as asymptomatic. Eventually, however, these mechanisms become detrimental, intravascular volume becomes too great, and progressive dilatation leads to heart failure symptoms.
  • #5 Dilated cardiomyopathy — Knowledge Hub
    https://www.genomicseducation.hee.nhs.uk/genotes/knowledge-hub/dilated-cardiomyopathy/
    Signs and symptoms of heart failure are often the presenting symptoms of dilated cardiomyopathy (DCM). These include: breathlessness; reduced exercise tolerance; and peripheral oedema. […] However, affected individuals can be asymptomatic, even if their cardiac dysfunction is advanced. Palpitations and pre-syncope or syncope may be the result of atrial or ventricular arrhythmias, or of atrio-ventricular conduction disease. […] Risk of sudden cardiac death due to ventricular arrhythmias is particularly elevated when there is severe systolic impairment. However, some genetic causes of DCM are associated with elevated risk of sudden cardiac death even when systolic function is relatively preserved. […] The most frequent causes of morbidity and mortality are: progressive heart failure; sudden arrhythmic death; conduction disease; and thrombo-embolism.
  • #6 Clinical Presentation, Spectrum of Disease, and Natural History – Dilated Cardiomyopathy – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK553846/
    Dilated cardiomyopathy (DCM) represents the third most common cause of heart failure (HF) and the most frequent cause of heart transplantation in the western world. […] In old series, initial symptoms of heart failure were present in 80% of patients with DCM. These symptoms include excessive sweating, orthopnea, and fatigue after mild exertion. Abdominal discomfort, nausea, anorexia, and cachexia can be prominent in advanced cases. Circulatory collapse is the most severe manifestation of congestive heart failure. Thromboembolic events and, rarely, sudden cardiac death (SCD) might be the initial symptom, particularly in infants. Other symptoms include those related to ventricular or supraventricular arrhythmias (i.e., palpitations, syncope, fatigue). […] Despite recent advances in medical treatment, LV dysfunction associated with signs of congestive heart failure (HF) is characterized by significant mortality. Patients may progress through an asymptomatic phase of LV systolic dysfunction of various degrees, from mild to severe, before the development of overt HF.
  • #7 Dilated cardiomyopathy – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/dilated-cardiomyopathy/symptoms-causes/syc-20353149
    Dilated cardiomyopathy causes the chambers of the heart to grow larger. Untreated, dilated cardiomyopathy can lead to heart failure. […] Symptoms of dilated cardiomyopathy such as fatigue and shortness of breath can mimic other health conditions. A person with dilated cardiomyopathy might not notice any symptoms at first. But dilated cardiomyopathy can become life-threatening. It’s a common cause of heart failure. […] Some people with dilated cardiomyopathy don’t have any signs or symptoms in the early stages of the disease. […] Signs and symptoms of dilated cardiomyopathy may include: Fatigue, Shortness of breath (dyspnea) during activity or while lying down, Reduced ability to exercise, Swelling (edema) in the legs, ankles, feet or belly (abdomen), Chest pain or discomfort, Fast, fluttering or pounding heartbeat (palpitations).
  • #8 Dilated Cardiomyopathy: Symptoms and Treatment
    https://my.clevelandclinic.org/health/diseases/16932-dilated-cardiomyopathy
    Many people with dilated cardiomyopathy dont have any symptoms, especially in the early stages. But as heart function worsens, you may notice symptoms more and more. […] Dilated cardiomyopathy symptoms may include: Chest pain, Cough and congestion, Dizziness or lightheadedness, Fainting, Fatigue (unusual tiredness), Palpitations or fluttering in your chest, Shortness of breath (dyspnea), Swelling in your belly, legs, ankles and feet (edema), Unexpected weight gain from fluid retention. […] Your prognosis depends on the cause and severity of the disease. With ongoing care, you may return to work and your usual daily activities. But you may have symptoms that get worse with time. Advanced dilated cardiomyopathy or complications can make you severely ill. You may need to stay in the hospital until symptoms improve.
  • #9 Dilated Cardiomyopathy – Cardiovascular Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/cardiovascular-disorders/cardiomyopathies/dilated-cardiomyopathy
    Dilated cardiomyopathy is myocardial dysfunction causing heart failure in which ventricular dilation and systolic dysfunction predominate. Symptoms include dyspnea, fatigue, and peripheral edema. […] Onset of dilated cardiomyopathy is usually gradual except in acute myocarditis, acute apical ballooning cardiomyopathy, and tachyarrhythmia-induced cardiomyopathy. About 25% of all patients with dilated cardiomyopathy have atypical chest pain. Other symptoms depend on which ventricle is affected. […] Left ventricular dysfunction causes exertional dyspnea and fatigue due to elevated left ventricular diastolic pressure and low cardiac output. […] Right ventricular failure causes peripheral edema and neck vein distention. Infrequently the right ventricle is predominantly affected in younger patients, and atrial arrhythmias and sudden death due to malignant ventricular tachyarrhythmias are typical.
  • #10 Cardiomyopathy – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/cardiomyopathy/symptoms-causes/syc-20370709
    Some people with cardiomyopathy don’t ever get symptoms. For others, symptoms appear as the condition becomes worse. Cardiomyopathy symptoms can include: Shortness of breath or trouble breathing with activity or even at rest. Chest pain, especially after physical activity or heavy meals. Heartbeats that feel rapid, pounding or fluttering. Swelling of the legs, ankles, feet, stomach area and neck veins. Bloating of the stomach area due to fluid buildup. Cough while lying down. Trouble lying flat to sleep. Fatigue, even after getting rest. Dizziness. Fainting. […] Symptoms tend to get worse unless they are treated. In some people, the condition becomes worse quickly. In others, it might not become worse for a long time. […] Dilated cardiomyopathy causes the chambers of the heart to grow larger. Untreated, dilated cardiomyopathy can lead to heart failure.
  • #11 Dilated Cardiomyopathy – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK441911/
    Classic symptoms include paroxysmal nocturnal dyspnea, orthopnea, leg swelling, and shortness of breath. Nonspecific symptoms of fatigue, malaise, and weakness also can be present. More severe cases can present with thromboembolic complications, conduction disturbances, arrhythmias or even sudden cardiac death. […] The majority of cases of dilated cardiomyopathy (DCM) present between the ages of 20 and 60; however, DCM can be seen in children or the elderly. A large number of patients with DCM may have a long latent period where they are clinically asymptomatic. When symptoms do arise, they are the result of LV systolic dysfunction. […] Overall, the prognosis of patients with dilated cardiomyopathy is guarded. Most patients eventually end up with chronic heart failure. Many become candidates for a heart transplant or an assist device which also adds more morbidity. The progression to heart failure depends on the ejection fraction and cause of the disease. Almost 50% of patients are dead within 5 years. […] The outcomes of patients with dilated cardiomyopathy depend on the cause, ejection fraction, and comorbidity. At least 50% are dead within five years, and many others go on to develop heart failure.
  • #12 Dilated cardiomyopathy: Signs, causes, and treatment
    https://www.medicalnewstoday.com/articles/dilated-heart-disease
    Dilated cardiomyopathy (DCM) occurs when the ventricles of the heart dilate and weaken, reducing the hearts ability to pump enough blood. […] DCM usually begins causing symptoms in people between 20 and 60 years old. It can also occur in older adults and children. […] The symptoms of DCM may develop gradually or suddenly and can vary widely among individuals. Symptoms can include: breathlessness when active or lying down, fatigue and weakness, swelling in the legs, ankles, and feet, irregular heartbeats that feel rapid, pounding, or fluttering, chest pain or discomfort, dizziness, lightheadedness, and fainting. […] Doctors classify the progression of symptoms into four stages: Stage A: A person has risk factors for DCM but no symptoms. Stage B: A person has no symptoms but does have clinical signs of ventricular dysfunction, heart valve disease, heart failure, or previous myocardial infarction. Stage C: A person has symptoms and a limitation in physical activities. Mild exertion, such as walking short distances, may lead to shortness of breath and fatigue. Stage D: A person has severe symptoms that occur while at rest despite admissions to the hospital and thorough medical treatment.
  • #13 Dilated Cardiomyopathy Symptoms | Stanford Health Care
    https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/familial-dilated-cardiomyopathy/symptoms.html
    Patients with dilated cardiomyopathy may have no, subtle, or overt symptoms. […] Common symptoms in familial dilated cardiomyopathy may include shortness of breath with exertion, fatigue, abdominal swelling, lower leg swelling, nausea, chest pain, chest pressure, palpitations, skipped beats, dizziness and/or fainting. […] In some cases, patients with dilated cardiomyopathy can be completely without symptoms (asymptomatic), and have normal tolerance for exercise and activities. […] In rare cases, the first symptom of dilated cardiomyopathy can be sudden death.
  • #14 Dilated cardiomyopathy Information | Mount Sinai – New York
    https://www.mountsinai.org/health-library/diseases-conditions/dilated-cardiomyopathy
    Dilated cardiomyopathy is a condition in which the heart muscle becomes weakened and enlarged. As a result, the heart cannot pump enough blood to the rest of the body. […] Symptoms of heart failure are most common. They most often develop slowly over time. However, sometimes symptoms start very suddenly and may be severe. […] Common symptoms are: Chest pain or pressure (more likely with exercise), Cough, Fatigue, weakness, faintness, Irregular or rapid pulse, Loss of appetite, Shortness of breath with activity or after lying down (or being asleep) for a while, Swelling of feet and ankles. […] Chronic heart failure becomes worse over time. Many people who have heart failure will die from the condition. […] Heart failure is most often a chronic illness, which may get worse over time. Some people develop severe heart failure, in which medicines, other treatments, and surgery no longer help. Many people are at risk for deadly heart rhythms, and may need medicines or a defibrillator.
  • #15 Clinical Presentation, Spectrum of Disease, and Natural History – Dilated Cardiomyopathy – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK553846/
    Most patients affected by DCM who present clinically with HF show symptoms and signs due to excess fluid accumulation (dyspnea, orthopnea, edema, pain from hepatic congestion, and abdominal discomfort due to ascites), sometimes associated with those due to a reduction in cardiac output (fatigue, weakness). […] In the past, the prognosis of DCM was considered ominous, and the disease was frequently progressive to death due to HF or heart transplantation. […] However, implementation of optimal pharmacological and non-pharmacological treatments has dramatically improved the prognosis of DCM with an estimated survival free from death or heart transplantation up to 85% at 10 years. […] The improved outcomes in DCM are paralleled by a higher rate of LV reverse remodeling (LVRR): in recent years several studies revealed that almost 40% of patients experience a significant LVRR when treated with evidence-based pharmacological and device treatments.
  • #16 Dilated Cardiomyopathy – Cardiovascular Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/cardiovascular-disorders/cardiomyopathies/dilated-cardiomyopathy
    Dilated cardiomyopathy is myocardial dysfunction causing heart failure in which ventricular dilation and systolic dysfunction predominate. Symptoms include dyspnea, fatigue, and peripheral edema. […] Onset of dilated cardiomyopathy is usually gradual except in acute myocarditis, acute apical ballooning cardiomyopathy, and tachyarrhythmia-induced cardiomyopathy. About 25% of all patients with dilated cardiomyopathy have atypical chest pain. Other symptoms depend on which ventricle is affected. […] Left ventricular dysfunction causes exertional dyspnea and fatigue due to elevated left ventricular diastolic pressure and low cardiac output. […] Right ventricular failure causes peripheral edema and neck vein distention. Infrequently the right ventricle is predominantly affected in younger patients, and atrial arrhythmias and sudden death due to malignant ventricular tachyarrhythmias are typical.
  • #17 Dilated Cardiomyopathy (DCM) | American Stroke Association
    https://www.stroke.org/en/health-topics/cardiomyopathy/what-is-cardiomyopathy-in-adults/dilated-cardiomyopathy-dcm
    Dilated cardiomyopathy (DCM) is the most common type, occurring mostly in adults younger than 50. It affects the heart’s ventricles and atria, the lower and upper chambers of the heart. […] Frequently, the disease starts in the left ventricle, the heart’s main pumping chamber. The heart muscle begins to dilate, stretching and becoming thinner. As a result, the inside of the chamber enlarges. The problem often spreads to the right ventricle and then to the atria. […] As the heart chambers dilate, the heart muscle doesn’t contract normally and can’t pump blood very well. As the heart becomes weaker, heart failure can occur. Common symptoms of heart failure include shortness of breath, fatigue and swelling of the ankles, feet, legs, abdomen and veins in the neck. […] Dilated cardiomyopathy also can lead to heart valve problems, arrhythmias (irregular heartbeats) and blood clots in the heart.
  • #18 Dilated Cardiomyopathy: Symptoms and Treatment
    https://my.clevelandclinic.org/health/diseases/16932-dilated-cardiomyopathy
    Dilated cardiomyopathy can get worse for many people and lead to long-term heart failure. This means your heart cant keep up with the demands on it. Kidney failure and severe heart failure are signs of a poor prognosis (outcome). People who have symptoms at rest or cant do physical activity tend to have the worst prognosis. […] Still, the prognosis for people with dilated cardiomyopathy has improved in recent years. This is due to the treatments available and early diagnosis and treatment. Today, more than 80% of people with this condition are alive at their eight-year follow-up visit and dont need a heart transplant.
  • #19 Dilated Cardiomyopathy – Cardiovascular Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/cardiovascular-disorders/cardiomyopathies/dilated-cardiomyopathy
    Prognosis for dilated cardiomyopathy generally has been poor, although prognosis has improved with current management regimens. About 20% of patients die in the first year and then about 10%/year thereafter; about 40 to 50% of deaths are sudden, due to a malignant arrhythmia. […] Prognosis is better if compensatory hypertrophy preserves ventricular wall thickness and is worse if ventricular walls thin markedly and the ventricle dilates. Patients whose dilated cardiomyopathy is well-compensated with treatment may be stable for many years.
  • #20 Stages of Heart Failure – Dilated Cardiomyopathy | DCM
    https://dcmfoundation.org/about-dilated-cardiomyopathy/stages-heart-failure-dilated-cardiomyopathy/
    Heart failure is a constellation of signs and symptoms that can be caused by DCM. […] Symptoms of heart failure due to dilated cardiomyopathy can improve, or they can worsen, so one can move back and forth across the classes. […] Symptoms of heart failure have now occurred with changes to the heart structure. Symptoms include fatigue, shortness of breath, and decreased exercise tolerance (refer to symptoms of heart failure), systolic dysfunction (reduced heart pumping function), abnormalities to the heart valves, and enlargement of the heart. […] Stage D is characterized by structural changes to the heart and refractory heart failure symptoms that occur at rest, despite optimal therapies.
  • #21 Dilated cardiomyopathy: Signs, causes, and treatment
    https://www.medicalnewstoday.com/articles/dilated-heart-disease
    Dilated cardiomyopathy (DCM) occurs when the ventricles of the heart dilate and weaken, reducing the hearts ability to pump enough blood. […] DCM usually begins causing symptoms in people between 20 and 60 years old. It can also occur in older adults and children. […] The symptoms of DCM may develop gradually or suddenly and can vary widely among individuals. Symptoms can include: breathlessness when active or lying down, fatigue and weakness, swelling in the legs, ankles, and feet, irregular heartbeats that feel rapid, pounding, or fluttering, chest pain or discomfort, dizziness, lightheadedness, and fainting. […] Doctors classify the progression of symptoms into four stages: Stage A: A person has risk factors for DCM but no symptoms. Stage B: A person has no symptoms but does have clinical signs of ventricular dysfunction, heart valve disease, heart failure, or previous myocardial infarction. Stage C: A person has symptoms and a limitation in physical activities. Mild exertion, such as walking short distances, may lead to shortness of breath and fatigue. Stage D: A person has severe symptoms that occur while at rest despite admissions to the hospital and thorough medical treatment.
  • #22 Early Signs and Symptoms of DCM — Reduced Heart Muscle Function
    https://dcmfoundation.org/about-dilated-cardiomyopathy/dilated-cardiomyopathy-and-symptoms-of-heart-failure/mild-symptoms-class-ii/
    A person with Dilated Cardiomyopathy (DCM) may notice that they fatigue easier or have mild shortness of breath during usual physical activities. This may cause slight limitation, meaning they need to stop and rest sooner, or more often, during usual activities. […] Most people with mild, or Class II, symptoms are still able to work. […] This is hard to predict. For some people with DCM, symptoms will stay the same or improve slightly. While for others, symptoms may progress with time. Occasionally there are other people who may have an improvement in their symptoms to such a degree that they no longer have symptoms. What is predictable is that the chances of symptoms getting worse, and/or a person dying sooner, are much higher for people who do not take the essential medications.
  • #23 Dilated cardiomyopathy – Wikipedia
    https://en.wikipedia.org/wiki/Dilated_cardiomyopathy
    The progression of heart failure is associated with left ventricular remodeling, which manifests as gradual increases in left ventricular end-diastolic and end-systolic volumes, wall thinning, and a change in chamber geometry to a more spherical, less elongated shape. This process is usually associated with a continuous decline in ejection fraction.
  • #24 Dilated cardiomyopathy – Wikipedia
    https://en.wikipedia.org/wiki/Dilated_cardiomyopathy
    Dilated cardiomyopathy (DCM) is a condition in which the heart becomes enlarged and cannot pump blood effectively. Symptoms vary from none to feeling tired, leg swelling, and shortness of breath. It may also result in chest pain or fainting. Complications can include heart failure, heart valve disease, or an irregular heartbeat. […] Dilated cardiomyopathy develops insidiously, and may not initially cause symptoms significant enough to impact on quality of life. Nevertheless, many people experience significant symptoms. These might include shortness of breath, syncope (fainting), and angina, but only in the presence of ischemic heart disease. […] As DCM progresses, two compensatory mechanisms are activated in response to impaired myocyte contractility and reduced stroke volume: Frank-Starling law and neurohormonal feedback, via activation of the sympathetic nervous system and the renin-angiotensin system. These responses initially compensate for decreased cardiac output and maintain those with DCM as asymptomatic. Eventually, however, these mechanisms become detrimental, intravascular volume becomes too great, and progressive dilatation leads to heart failure symptoms.
  • #25 Dilated cardiomyopathy – Wikipedia
    https://en.wikipedia.org/wiki/Dilated_cardiomyopathy
    Dilated cardiomyopathy (DCM) is a condition in which the heart becomes enlarged and cannot pump blood effectively. Symptoms vary from none to feeling tired, leg swelling, and shortness of breath. It may also result in chest pain or fainting. Complications can include heart failure, heart valve disease, or an irregular heartbeat. […] Dilated cardiomyopathy develops insidiously, and may not initially cause symptoms significant enough to impact on quality of life. Nevertheless, many people experience significant symptoms. These might include shortness of breath, syncope (fainting), and angina, but only in the presence of ischemic heart disease. […] As DCM progresses, two compensatory mechanisms are activated in response to impaired myocyte contractility and reduced stroke volume: Frank-Starling law and neurohormonal feedback, via activation of the sympathetic nervous system and the renin-angiotensin system. These responses initially compensate for decreased cardiac output and maintain those with DCM as asymptomatic. Eventually, however, these mechanisms become detrimental, intravascular volume becomes too great, and progressive dilatation leads to heart failure symptoms.
  • #26 Dilated cardiomyopathy – Wikipedia
    https://en.wikipedia.org/wiki/Dilated_cardiomyopathy
    Dilated cardiomyopathy (DCM) is a condition in which the heart becomes enlarged and cannot pump blood effectively. Symptoms vary from none to feeling tired, leg swelling, and shortness of breath. It may also result in chest pain or fainting. Complications can include heart failure, heart valve disease, or an irregular heartbeat. […] Dilated cardiomyopathy develops insidiously, and may not initially cause symptoms significant enough to impact on quality of life. Nevertheless, many people experience significant symptoms. These might include shortness of breath, syncope (fainting), and angina, but only in the presence of ischemic heart disease. […] As DCM progresses, two compensatory mechanisms are activated in response to impaired myocyte contractility and reduced stroke volume: Frank-Starling law and neurohormonal feedback, via activation of the sympathetic nervous system and the renin-angiotensin system. These responses initially compensate for decreased cardiac output and maintain those with DCM as asymptomatic. Eventually, however, these mechanisms become detrimental, intravascular volume becomes too great, and progressive dilatation leads to heart failure symptoms.
  • #27 Clinical Presentation, Spectrum of Disease, and Natural History – Dilated Cardiomyopathy – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK553846/
    In spite of this therapeutic success, emerging evidence suggests that some patients remain vulnerable to SCD and refractory HF requiring heart transplant or mechanical circulatory support. […] Thus, the outcome of patients with DCM often remains unpredictable, and major adverse events may occur in the first months following the diagnosis.
  • #28 Dilated Cardiomyopathy – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK441911/
    Dilated Cardiomyopathy (DCM) is a disease of the heart muscle characterized by enlargement and dilation of one or both of the ventricles along with impaired contractility defined as left ventricular ejection fraction (LVEF) less than 40%. By definition, patients have systolic dysfunction and may or may not have overt symptoms of heart failure. […] In most cases DCM is progressive, leading to heart failure and death. Without a transplant, the survival rates are poor. […] While most patients with DCM have symptoms, a few patients may be asymptomatic because of the compensatory mechanisms. The continued enlargement of the ventricles leads to a decline in ventricular function, followed by conduction system abnormalities, ventricular arrhythmias, thromboembolism, and heart failure. The earlier these patients are identified and treated, the better the prognosis.
  • #29 Dilated Cardiomyopathy (DCM) | American Stroke Association
    https://www.stroke.org/en/health-topics/cardiomyopathy/what-is-cardiomyopathy-in-adults/dilated-cardiomyopathy-dcm
    Dilated cardiomyopathy (DCM) is the most common type, occurring mostly in adults younger than 50. It affects the heart’s ventricles and atria, the lower and upper chambers of the heart. […] Frequently, the disease starts in the left ventricle, the heart’s main pumping chamber. The heart muscle begins to dilate, stretching and becoming thinner. As a result, the inside of the chamber enlarges. The problem often spreads to the right ventricle and then to the atria. […] As the heart chambers dilate, the heart muscle doesn’t contract normally and can’t pump blood very well. As the heart becomes weaker, heart failure can occur. Common symptoms of heart failure include shortness of breath, fatigue and swelling of the ankles, feet, legs, abdomen and veins in the neck. […] Dilated cardiomyopathy also can lead to heart valve problems, arrhythmias (irregular heartbeats) and blood clots in the heart.
  • #30 Dilated cardiomyopathy — Knowledge Hub
    https://www.genomicseducation.hee.nhs.uk/genotes/knowledge-hub/dilated-cardiomyopathy/
    Signs and symptoms of heart failure are often the presenting symptoms of dilated cardiomyopathy (DCM). These include: breathlessness; reduced exercise tolerance; and peripheral oedema. […] However, affected individuals can be asymptomatic, even if their cardiac dysfunction is advanced. Palpitations and pre-syncope or syncope may be the result of atrial or ventricular arrhythmias, or of atrio-ventricular conduction disease. […] Risk of sudden cardiac death due to ventricular arrhythmias is particularly elevated when there is severe systolic impairment. However, some genetic causes of DCM are associated with elevated risk of sudden cardiac death even when systolic function is relatively preserved. […] The most frequent causes of morbidity and mortality are: progressive heart failure; sudden arrhythmic death; conduction disease; and thrombo-embolism.
  • #31 Dilated Cardiomyopathy – Cardiovascular Genetics | UCLA Health
    https://www.uclahealth.org/medical-services/heart/genetics/conditions/dilated-cardiomyopathy
    Dilated cardiomyopathy might not cause symptoms, but for some people it can be life-threatening. A common cause of heart failure the heart’s inability to supply the body with enough blood dilated cardiomyopathy can also contribute to irregular heartbeats (arrhythmias), blood clots or sudden death. […] If you have dilated cardiomyopathy, you’re likely to have signs and symptoms of heart failure or arrhythmias caused by your condition. Signs and symptoms include: Fatigue, Shortness of breath (dyspnea) when you’re active or lying down, Reduced ability to exercise, Swelling (edema) in your legs, ankles and feet, Swelling of your abdomen (ascites). […] Complications from dilated cardiomyopathy include: Heart failure, Heart valve regurgitation, Fluid buildup (edema), Abnormal heart rhythm (arrhythmia), Sudden cardiac arrest, Blood clots (emboli).
  • #32 Dilated cardiomyopathy — Knowledge Hub
    https://www.genomicseducation.hee.nhs.uk/genotes/knowledge-hub/dilated-cardiomyopathy/
    Signs and symptoms of heart failure are often the presenting symptoms of dilated cardiomyopathy (DCM). These include: breathlessness; reduced exercise tolerance; and peripheral oedema. […] However, affected individuals can be asymptomatic, even if their cardiac dysfunction is advanced. Palpitations and pre-syncope or syncope may be the result of atrial or ventricular arrhythmias, or of atrio-ventricular conduction disease. […] Risk of sudden cardiac death due to ventricular arrhythmias is particularly elevated when there is severe systolic impairment. However, some genetic causes of DCM are associated with elevated risk of sudden cardiac death even when systolic function is relatively preserved. […] The most frequent causes of morbidity and mortality are: progressive heart failure; sudden arrhythmic death; conduction disease; and thrombo-embolism.
  • #33 Dilated Cardiomyopathy (DCM): Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/152696-overview
    The prognosis for patients with HF depends on several factors, with the etiology of disease being the primary factor. […] Other factors play important roles in determining prognosis; for example, higher mortality is associated with increased age, male sex, and severe congestive HF. […] The Framingham Heart Study found that approximately 50% of patients diagnosed with congestive HF died within 5 years. […] Patients with severe HF have more than a 50% yearly mortality. […] Patients with mild HF have significantly better prognoses, especially with optimal medical therapy. […] Individuals with a high likelihood of myocardial recovery following appropriate therapy include those with alcohol-induced cardiomyopathy, hypertensive cardiomyopathy, tachycardia-induced cardiomyopathy, Takotsubo cardiomyopathy, or ischemic cardiomyopathy after revascularization.
  • #34 Dilated Cardiomyopathy – Cardiovascular Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/cardiovascular-disorders/cardiomyopathies/dilated-cardiomyopathy
    Prognosis for dilated cardiomyopathy generally has been poor, although prognosis has improved with current management regimens. About 20% of patients die in the first year and then about 10%/year thereafter; about 40 to 50% of deaths are sudden, due to a malignant arrhythmia. […] Prognosis is better if compensatory hypertrophy preserves ventricular wall thickness and is worse if ventricular walls thin markedly and the ventricle dilates. Patients whose dilated cardiomyopathy is well-compensated with treatment may be stable for many years.
  • #35 Dilated Cardiomyopathy (DCM): Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/152696-overview
    The prognosis for patients with HF depends on several factors, with the etiology of disease being the primary factor. […] Other factors play important roles in determining prognosis; for example, higher mortality is associated with increased age, male sex, and severe congestive HF. […] The Framingham Heart Study found that approximately 50% of patients diagnosed with congestive HF died within 5 years. […] Patients with severe HF have more than a 50% yearly mortality. […] Patients with mild HF have significantly better prognoses, especially with optimal medical therapy. […] Individuals with a high likelihood of myocardial recovery following appropriate therapy include those with alcohol-induced cardiomyopathy, hypertensive cardiomyopathy, tachycardia-induced cardiomyopathy, Takotsubo cardiomyopathy, or ischemic cardiomyopathy after revascularization.
  • #36
    https://www.nccs.com.sg/patient-care/conditions-treatments/dilated-cardiomyopathy
    Some patients may not experience any symptoms if the condition is mild. Most symptomatic patients complain of reduced effort tolerance. […] Other symptoms can include: Breathlessness on lying down, Leg swelling, Fatigue. […] It is important to start treatment as soon as possible, as dilated cardiomyopathy causes increased risks of death and hospitalisation. Studies have shown that on average, one out of five patients pass away from their weak heart function within a year of diagnosis. Nearly half of all patients may get readmitted within a year.
  • #37 Dilated Cardiomyopathy: Symptoms and Treatment
    https://my.clevelandclinic.org/health/diseases/16932-dilated-cardiomyopathy
    Dilated cardiomyopathy can get worse for many people and lead to long-term heart failure. This means your heart cant keep up with the demands on it. Kidney failure and severe heart failure are signs of a poor prognosis (outcome). People who have symptoms at rest or cant do physical activity tend to have the worst prognosis. […] Still, the prognosis for people with dilated cardiomyopathy has improved in recent years. This is due to the treatments available and early diagnosis and treatment. Today, more than 80% of people with this condition are alive at their eight-year follow-up visit and dont need a heart transplant.
  • #38 Dilated Cardiomyopathy (DCM): Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/152696-overview
    The prognosis for patients with HF depends on several factors, with the etiology of disease being the primary factor. […] Other factors play important roles in determining prognosis; for example, higher mortality is associated with increased age, male sex, and severe congestive HF. […] The Framingham Heart Study found that approximately 50% of patients diagnosed with congestive HF died within 5 years. […] Patients with severe HF have more than a 50% yearly mortality. […] Patients with mild HF have significantly better prognoses, especially with optimal medical therapy. […] Individuals with a high likelihood of myocardial recovery following appropriate therapy include those with alcohol-induced cardiomyopathy, hypertensive cardiomyopathy, tachycardia-induced cardiomyopathy, Takotsubo cardiomyopathy, or ischemic cardiomyopathy after revascularization.
  • #39 Clinical Presentation, Spectrum of Disease, and Natural History – Dilated Cardiomyopathy – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK553846/
    Most patients affected by DCM who present clinically with HF show symptoms and signs due to excess fluid accumulation (dyspnea, orthopnea, edema, pain from hepatic congestion, and abdominal discomfort due to ascites), sometimes associated with those due to a reduction in cardiac output (fatigue, weakness). […] In the past, the prognosis of DCM was considered ominous, and the disease was frequently progressive to death due to HF or heart transplantation. […] However, implementation of optimal pharmacological and non-pharmacological treatments has dramatically improved the prognosis of DCM with an estimated survival free from death or heart transplantation up to 85% at 10 years. […] The improved outcomes in DCM are paralleled by a higher rate of LV reverse remodeling (LVRR): in recent years several studies revealed that almost 40% of patients experience a significant LVRR when treated with evidence-based pharmacological and device treatments.
  • #40 Dilated Cardiomyopathy: Symptoms and Treatment
    https://my.clevelandclinic.org/health/diseases/16932-dilated-cardiomyopathy
    Dilated cardiomyopathy can get worse for many people and lead to long-term heart failure. This means your heart cant keep up with the demands on it. Kidney failure and severe heart failure are signs of a poor prognosis (outcome). People who have symptoms at rest or cant do physical activity tend to have the worst prognosis. […] Still, the prognosis for people with dilated cardiomyopathy has improved in recent years. This is due to the treatments available and early diagnosis and treatment. Today, more than 80% of people with this condition are alive at their eight-year follow-up visit and dont need a heart transplant.
  • #41 Clinical Presentation, Spectrum of Disease, and Natural History – Dilated Cardiomyopathy – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK553846/
    Most patients affected by DCM who present clinically with HF show symptoms and signs due to excess fluid accumulation (dyspnea, orthopnea, edema, pain from hepatic congestion, and abdominal discomfort due to ascites), sometimes associated with those due to a reduction in cardiac output (fatigue, weakness). […] In the past, the prognosis of DCM was considered ominous, and the disease was frequently progressive to death due to HF or heart transplantation. […] However, implementation of optimal pharmacological and non-pharmacological treatments has dramatically improved the prognosis of DCM with an estimated survival free from death or heart transplantation up to 85% at 10 years. […] The improved outcomes in DCM are paralleled by a higher rate of LV reverse remodeling (LVRR): in recent years several studies revealed that almost 40% of patients experience a significant LVRR when treated with evidence-based pharmacological and device treatments.
  • #42 Dilated Cardiomyopathy: Symptoms and Treatment
    https://my.clevelandclinic.org/health/diseases/16932-dilated-cardiomyopathy
    Dilated cardiomyopathy can get worse for many people and lead to long-term heart failure. This means your heart cant keep up with the demands on it. Kidney failure and severe heart failure are signs of a poor prognosis (outcome). People who have symptoms at rest or cant do physical activity tend to have the worst prognosis. […] Still, the prognosis for people with dilated cardiomyopathy has improved in recent years. This is due to the treatments available and early diagnosis and treatment. Today, more than 80% of people with this condition are alive at their eight-year follow-up visit and dont need a heart transplant.
  • #43 Clinical Presentation, Spectrum of Disease, and Natural History – Dilated Cardiomyopathy – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK553846/
    Most patients affected by DCM who present clinically with HF show symptoms and signs due to excess fluid accumulation (dyspnea, orthopnea, edema, pain from hepatic congestion, and abdominal discomfort due to ascites), sometimes associated with those due to a reduction in cardiac output (fatigue, weakness). […] In the past, the prognosis of DCM was considered ominous, and the disease was frequently progressive to death due to HF or heart transplantation. […] However, implementation of optimal pharmacological and non-pharmacological treatments has dramatically improved the prognosis of DCM with an estimated survival free from death or heart transplantation up to 85% at 10 years. […] The improved outcomes in DCM are paralleled by a higher rate of LV reverse remodeling (LVRR): in recent years several studies revealed that almost 40% of patients experience a significant LVRR when treated with evidence-based pharmacological and device treatments.
  • #44 Dilated Cardiomyopathy (DCM): Symptoms, Causes, Treatment, Outlook
    https://www.healthline.com/health/heart-disease/dilated-cardiomyopathy
    In its early stages, DCM may cause no symptoms. But over time, the following signs and symptoms of heart failure may develop: chest pain, fatigue, heart palpitations, reduced endurance while exercising, shortness of breath, swelling in the abdomen or lower legs. […] If DCM has led to severe heart failure, it may be necessary to have a heart transplant. […] The overall prognosis for people diagnosed with DCM continues to improve, provided they receive a proper diagnosis and the correct treatment. […] Research in 2021 suggests that about 15% of individuals with DCM who receive proper treatment experience a return to healthy left ventricle size and function, and this number may increase with newer heart failure therapies. […] Additionally, with treatment, more than 80% of individuals are able to survive without the need for a heart transplant.
  • #45 Clinical Presentation, Spectrum of Disease, and Natural History – Dilated Cardiomyopathy – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK553846/
    In spite of this therapeutic success, emerging evidence suggests that some patients remain vulnerable to SCD and refractory HF requiring heart transplant or mechanical circulatory support. […] Thus, the outcome of patients with DCM often remains unpredictable, and major adverse events may occur in the first months following the diagnosis.
  • #46 Dilated cardiomyopathy — Knowledge Hub
    https://www.genomicseducation.hee.nhs.uk/genotes/knowledge-hub/dilated-cardiomyopathy/
    Some genetic causes of DCM are associated with more aggressive natural histories than others. In these more aggressive forms, cardiac complications (including ventricular arrhythmias, conduction disease, severe systolic impairment and myocardial fibrosis) occur earlier in the natural history of the disease. […] Assessment of prognostic risks, including sudden arrhythmic death, thrombo-embolic disease, conduction disease and progressive heart failure.

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