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| X-ray can visually detect Dilated Cardiomyopathy |
In general, Dilated Cardiomyopathy is a condition in which the heart
becomes weak, dilated, and losing its capability to pump blood through the
blood vessel efficiently. It will definitely affect the organs system
such as lungs, liver, kidney, etc.
DCM is just one of the
cardiomyopathies, a kind of diseases that attack myocardium/heart muscle.
In DCM, a part of myocardium is enlarged, and in some cases it happens without
any obvious cause (Ischemic). Mostly left rather than right ventricular systolic
pump function of the heart is broken; leading to progressive cardiac
enlargement including hypertrophy, the process is called ventricle
remodeling.
Ischemic Dilated
Cardiomyopathy is less common than DCM itself. It also occurs more
frequent in male than female, in age between 20-60 years. Averagely one
in three cases of Congestive Heart Failure (CHF) is due to DCM, and in some
case is found in children as well.
What does cause it?
What really interests me is that
the silent killer usually has no appearance at all. The damaged
myocardium might be the result of exposure to a variety of toxic, metabolic, or
infectious agents. It may also be due to fibrous change of the myocardium from
a previous myocardial infarction. Or, it may be the late sequel of
acute viral myocarditis, such as Coxsackie’s B virus and other viruses, possibly mediated
through an immunologic mechanism.
Other causes include:
- It is known as Chagas disease, caused by trypanosoma cruzi, is the most common infectious that cause dilated cardiomyopathy in South America.
- Pregnancy. Dilated cardiomyopathy happens several weeks to months postpartum as a peripartum cardiomyopathy. The good thing is that it usually reversible.
- Alcohol bad effect (Alcoholic cardiomyopathy).
- Thyroid abnormalities or disease.
Sign and Symptoms
Dilated cardiomyopathy may not
cause symptoms significant enough to impact on quality of life. A minority of
patients can experience significant symptoms. These might include:
- Breathlessness
- Edema (from your stomach to the feet)
- Loss of consciousness or Syncope
- angina, but only in the presence of ischemic heart disease
- Coughing like bronchitis (some patient will react this way when taking Captopril)
A patient suffering from dilated
cardiomyopathy may have an enlarged heart, with lung edema and an elevated
jugular venous pressure and a low pulse of blood pressure. Signs of mitral and
tricuspid regurgitation may exist and also a steady tachycardia during the respiration
cycle.
Easy Diagnosis
In my case Electro Cardio Gram
hardly detect the problem, but simply have the thorax X-ray would reveal
enough. For more detail I suggest you ask the doctor to immediately use
Echo Cardio Gram or even MRI scanning for more accuracy. We need to know the
fraction ejection number of the heart, in order to get a precise medication and
other necessary treatment. My number is 26% left. It is perhaps too late
to save, regardless how much money you have to replace the old heart for the
new and healthy one. Most of the case, Congestive Heart Failure can leads
to a sudden death within minutes. Faster than the time we usually spend
to wait our turn to see the doctor. So that, a quick and more accurate test
might safe life accordingly.
Treatment in General
Drug therapy can slow down the
progression and in some cases even improve the heart condition. Once again in
some country like Indonesia,
where social/health security has not been equally applied to all citizens, financial
capability to pay the doctor and medicine could become another deadly dead
end. In my case, I'm not covered by social/health security. So I
have to choose wisely to spend my budget for my medication or for the future of
my family, because with my condition having a job or another income is a big
issue to solve.
Standard therapy may include:
- Salt restriction,
- Water/drink restriction between 1000 - 2000 ml per day depends on the condition.
- ACE Inhibitor, (Alpha blocker or Beta-Blocker - please be noted that Beta Blocker could rise up your Blood Sugar Level. It is a dilemma for me)
- Diuretics,
- Digitalis
- Anticoagulants.
Strictly avoid ALCOHOL
since it will disturb the heart pumping action rapidly. Smoking? I don't
want to suggest.
There is a fact for the advantages
of Coenzyme Q10 in treating heart failure. Other supplements may provide
D-Ribose, L-Carnitine, and Taurine. Please learn carefully about taurine,
because improper usage of it could harm other organs such as kidney. I
will try to elaborate more about Coenzyme Q10 later, but for now I just give
you a summary clue : consume soybean could help your heart to
recover.
Advance Treatment
Artificial pacemakers may be used
in patients with intraventricular conduction delay, and implantable
cardioverter-defibrillators in those at risk of arrhythmia. These forms of
treatment have been shown to improve symptoms and reduce hospitalization.
Patients with advanced disease who
are refractory to medical therapy, heart transplantation should be
considered. Hopefully no another dead end.
Reverse Modeling
This refers to reversing the
remodeling back to at least near normal condition. Therapies that
eligible to reverse remodeling have been studied, and this may suggest a new
approach to the prognosis of cardiomyopathies.
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