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- Shortness of breath, night cough, attacks of angina pectoris, heaviness in the right hypochondrium, swelling and other manifestations of dilated cardiomyopathy
Dilated cardiomyopathy is manifesteddiffuse expansion of the chambers of the heart and moderate hypertrophy of the myocardium. The pathogenesis is based on a decrease in the contractile function of the myocardium. The majority of patients in the ventricles form a parietal thrombus, leading to thromboembolism in the small and large circles of the circulation.
Clinical manifestations of dilated cardiomyopathy
In the early stages of dilated cardiomyopathySymptoms are scarce. With the development of heart failure, there are complaints of shortness of breath during physical exertion, and subsequently - and at rest. There are "night" cough, cardiac asthma, attacks of angina.
With further progression of the cardiacInsufficiency appears heaviness in the right hypochondrium due to the increase in the liver. There are swelling on the legs. Even during this period, cardiomegaly is revealed. The heart is widened in diameter, the apical impulse is shifted to the left and down.
Symptoms of defeat of the valvular heart apparatus are notattaching. Tachycardia, systolic murmur are detected against a background of relative insufficiency of the mitral or tricuspid valve. There may be various violations of the heart rhythm, most often - ventricular extrasystole and atrial fibrillation.
In the late stage of the disease there are signs of severe heart failure.
Methods for dilated cardiomyopathy
Using clinical and instrumental methodsthe presence of cardiomegaly is established. Echocardiography makes it possible to identify the expansion of the cavities of the ventricles of the heart, the paradoxical movement of the interventricular septum during the systole period. Electrocardiography examines signs of hypertrophy of the left ventricle and left atrium, blockade of the anterior branch of the left branch of the bundle of His.
The study of central hemodynamics makes it possible to detect a decrease in the minute and shock volumes of the circulation.
Differential diagnosis is performed with the following heart diseases:
- diffuse myocarditis;
- primary amyloidosis of the heart;
- coronary heart disease, in particular postinfarction cardiosclerosis, complicated by aneurysm of the heart;
- acquired heart defects.
In cases difficult for differential diagnosis, cases of intravital biopsy of the myocardium are used.
«Shortness of breath, night cough, attacks of angina pectoris, heaviness in the right hypochondrium, swelling and other manifestations of dilated cardiomyopathy »- article from section Cardiology
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