Diagnosis Of Dilated Cardiomyopathy

Dilated cardiomyopathy is a common clinical condition that can be diagnosed through various medical examinations. These tests help identify the structural and functional changes in the heart associated with this condition.

Imaging Techniques For Diagnosis

X-ray imaging often reveals an enlarged heart shadow, which in later stages may appear spherical, indicating enlargement of all heart chambers. This appearance can mimic pericardial effusion. In some cases, the left ventricle, left atrium, or right ventricle may be predominantly enlarged, resembling mitral valve disease. Fluoroscopic examination shows reduced cardiac motion. The aorta typically remains unaffected. Long-standing cases may exhibit signs of pulmonary congestion and interstitial edema, with septal lines visible at the lung costophrenic angles. Pulmonary veins and arteries may also appear enlarged.

Electrocardiogram (ECG)

ECG findings are often abnormal in patients with heart failure symptoms, and even some asymptomatic individuals may show ECG changes. These changes primarily involve cardiac hypertrophy, myocardial damage, and arrhythmias. Left ventricular hypertrophy is common and often accompanied by myocardial strain. Right ventricular hypertrophy may develop in later stages, and atrial enlargement—either left or right—can also occur.

Echocardiography

Transthoracic echocardiography is a key diagnostic tool. Even in the early stages of the disease, mild chamber enlargement can be detected. As the condition progresses, all heart chambers show enlargement, confirming the diagnosis of dilated cardiomyopathy.

Nuclear Imaging

Radionuclide ventriculography can also demonstrate chamber enlargement and hypokinesis of the ventricular walls. A reduced left ventricular ejection fraction is commonly observed, especially during physical exertion.

Invasive Diagnostic Procedures

Cardiac catheterization provides detailed hemodynamic information and helps rule out other forms of heart disease. Additionally, endomyocardial biopsy may be performed to assess for myocardial inflammation or other specific pathologies that could be contributing to the condition.