Cardiomyopathy - dilated
Description
- LV (or biventricular) dilatation + systolic dysfunction, not explained by loading conditions or coronary disease
- "Not explained by" is the whole definition - DCM is a diagnosis of exclusion after ischaemia, valve disease and hypertension are excluded
- Fundamentally a disease of the cardiomyocyte cytoskeleton and sarcomere - force generation and force transmission both fail
Related phenotypes (ESC 2023 cardiomyopathy framework)
| DCM | Dilatation + systolic dysfunction |
| Hypokinetic non-dilated cardiomyopathy (HNDC) | Systolic dysfunction WITHOUT dilatation - same genetics and prognosis; the early or arrhythmogenic form |
| Arrhythmogenic DCM | DCM + frequent ventricular arrhythmia disproportionate to the degree of dysfunction (LMNA, FLNC, PLN, DSP, RBM20) |
| Peripartum cardiomyopathy | Last month of pregnancy to 5 months postpartum |
- The shift away from "idiopathic DCM": most cases are now assigned a genetic, toxic, inflammatory or arrhythmic cause
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