Dilated cardiomyopathy (DCM) is a condition where the heart’s main pumping chamber, the left ventricle, becomes enlarged and weakened. This enlargement and weakening reduce the heart’s ability to pump blood efficiently throughout the body. Because the heart struggles to meet the body’s demands, a range of serious complications can develop over time, affecting not only the heart but also other organs and systems.
One of the most significant complications of dilated cardiomyopathy is **heart failure**. As the heart muscle weakens and the chambers enlarge, the heart cannot pump blood effectively. This leads to fluid buildup in the lungs, legs, and other parts of the body, causing symptoms like shortness of breath, swelling, and fatigue. The heart’s reduced pumping ability means vital organs receive less oxygen and nutrients, which can impair their function.
Another major complication is the development of **abnormal heart rhythms**, or arrhythmias. The structural changes in the heart caused by dilation make it more prone to irregular electrical activity. Common arrhythmias include atrial fibrillation, which can cause palpitations and increase the risk of stroke, and ventricular tachycardia, which can lead to fainting or sudden cardiac arrest. These rhythm disturbances can be life-threatening and often require medical intervention.
Because the heart chambers are enlarged and contract poorly, blood flow within the heart slows down, increasing the risk of **blood clots** forming inside the heart. These clots can break loose and travel through the bloodstream, potentially causing strokes or blockages in other organs. This risk is especially high if atrial fibrillation is present, as the irregular heartbeat promotes clot formation.
The enlargement of the heart can also affect the heart valves, particularly the mitral and tricuspid valves. When the heart chambers stretch, the valves may not close properly, leading to **valve regurgitation**—a condition where blood leaks backward instead of moving forward efficiently. This leakage increases the workload on the heart and worsens heart failure symptoms.
Over time, the strain on the heart can cause increased pressure in the lungs, known as **pulmonary hypertension**. This condition puts extra stress on the right side of the heart, which pumps blood to the lungs. The right ventricle may enlarge and weaken as well, leading to **right-sided heart failure**. This further complicates the clinical picture and can cause additional symptoms like swelling in the abdomen and legs.
Because the heart is less effective at circulating blood, other organs can suffer from reduced blood flow. This can lead to **end-organ damage**, particularly affecting the kidneys and liver. Poor kidney function can worsen fluid retention and electrolyte imbalances, while liver congestion can cause discomfort and impair liver function.
In some cases, dilated cardiomyopathy may be triggered or worsened by inflammation of the heart muscle, known as **myocarditis**. This inflammation can cause damage to heart muscle cells, leading to scarring and further weakening of the heart. Severe myocarditis can cause acute heart failure and may require long-term management.
Patients with dilated cardiomyopathy may also experience symptoms related to low cardiac output, such as **fatigue, dizziness, and fainting**, especially during physical activity. These symptoms reflect the heart’s inability to meet the body’s increased oxygen demands during exertion.
In advanced stages, when medical therapy and devices like pacemakers or defibrillators are insufficient, patients may require **heart transplantation**. This is considered when the heart’s function is severely compromised, and complications become life-threatening despite treatment.
In summary, the complications of dilated cardiomyopathy are wide-ranging and serious. They include heart failure, arrhythmias, blood clots, valve problems, pulmonary hypertension, right heart failure, and damage to other organs. These complications arise because the heart’s structure and function are severely impaired, leading to a cascade of problems that affect the entire body. Managing these complications require
