Heart Failure Symptoms and Signs of Dilated Cardiomyopathy

Dilated cardiomyopathy (DCM) is primarily characterized by an enlarged heart, heart failure, and various types of arrhythmias. These symptoms typically progress over time and can significantly impact a patient's quality of life. Below is a detailed overview of the common manifestations associated with this condition:

Early Stage Symptoms

In the initial stages of dilated cardiomyopathy, patients may not experience any noticeable symptoms. However, as the disease progresses and the heart begins to enlarge, individuals may notice a decrease in their ability to perform physical activities. This decline in exercise tolerance is often one of the first subtle signs of the condition.

Progressive Symptoms

As the heart's ability to pump blood becomes compromised, more pronounced symptoms begin to appear. One of the hallmark signs is paroxysmal nocturnal dyspnea — sudden shortness of breath that awakens individuals from sleep. Patients may need to sit upright or use extra pillows to breathe comfortably, indicating worsening heart function.

Advanced Stage Manifestations

At more advanced stages, patients may experience dyspnea even at rest. This means they feel breathless without engaging in any physical activity. Other associated symptoms include palpitations, fatigue, chest tightness, and a persistent cough. These signs are indicative of severe heart failure and require prompt medical attention.

Clinical Findings During Physical Examination

During a physical examination, healthcare providers may observe several key signs. On percussion, the cardiac borders may appear enlarged to the left and bilaterally. Additionally, heart sounds may be diminished, and the heart rate may be elevated. A common finding is the presence of a third heart sound, known as a gallop rhythm, which is typically heard during auscultation and suggests impaired ventricular filling.