Title: A Study to assess clinical and echocardiographic profile of patients with dilated cardiomyopathy

Authors: Dr Saurabh Singh Tomar, Dr Manisha Chauhan

 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.186

Abstract

Introduction: Cardiomyopathy is a primarily disorder of the heart muscle that causes abnormal myocardial performance and is not the result of disease or dysfunction of other cardiac structures.It is an important cause of heart failure and accounts for up to 25% of all cases of heart failure.

Materials and Methods: A total 50 patients who were admitted at tertiary care teaching institute of North India and fulfilled inclusion criteria were evaluated by history, clinical examination, Electrocardiograph (ECG) and Echocardiography.

Results: Majority of the patients were above the age of 60 years of which males comprised 56% and females comprised 44%. The clinical profile of patients included signs and symptoms of biventricular failure (80%) followed by left ventricular failure (16%). Echocardiography showed reduced ejection fraction and Global hypokinesia and dilatation of all four chambers were seen in all the patients. The most common type of DCM was ischemic comprising of 33% of all cardiomyopathies followed by diabetic cardiomyopathy (24%) and peripartum cardiomyopathy (18%).Idiopathic DCM was seen in 14% of cases. While alcoholic cardiomyopathy seen in 6%.Miscellaneous group included 6% of cases. Abnormalties of pulse rate rhythm included ectopic beats (53%), tachycardia (46%),atrial fibrillation (13%) and brady cardia(3%).

Chest x-ray, PA view showed cardiomegaly in all the cases while some patients had plueral effusion (20%).

Electrocardiograhic profile revealed ventricular ectopics (46%),sinus tachycardia(40%),Left bundle branch block,LBBB,(40%),right bundle branch block, RBBB, non specific ST-T changes(26%) and atrial fibrillation(13.3%).Echocardiography showed reduced ejection fraction and global hypokinesia in all the patients

Conclusion: Dilated cardiomyopathy is common and an important cause of heart failure in the elderly and middle aged population and the etiology varies with age.Biventricular failure was the most common clinical presentation(80%) followed by left ventricular failure(16%) and then right heart failure(3%).The most common type was Ischaemic.

References

  1. Libby P,Braunwald E,A Braunwald’s Heart Disease-Text book of Cardiovascular Medicine: The Cardiomyopathies 7th
  2. Kannel WB.Prevalence of congestive Heart failure in Framingham Heart study subjects.Circulation 1994;13:s107-12.
  3. Rabbani M,Zaheer M,Shirazi N.Clinical ECG Echocardiographic profile of patients with Dilated Cardiomyopathy.Indian J Cardio2005;8:25-9.
  4. Vijayaraghwan G.API Text book of Medicine Disorders of myocardium.7th edition page-490-1.
  5. Dennert R,Heymans S. Dilated Cardiomyopathy possible triggers and treatment strategies.Neth Heart 2012;20:332-5.

Corresponding Author

Dr Manisha Chauhan (M.S. Obstetrics & Gynaecology)