Volume 03 Issue 12-2023
13
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
12
P
AGES
:
13-18
SJIF
I
MPACT
FACTOR
(2021:
5.
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)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
Dilated cardiomyopathy is myocardial dysfunction causing heart failure in which ventricular dilation and systolic
dysfunction predominate. Symptoms include dyspnea, fatigue, and peripheral edema. Diagnosis is clinical and by
elevated natriuretic peptides, chest x-ray, echocardiography, and MRI. Treatment is directed at the cause. If heart
failure is progressive and severe, cardiac resynchronization therapy, implantable cardioverter-defibrillator, repair of
moderate to severe valvular regurgitation, left ventricular assist device, or heart transplantation may be needed.
KEYWORDS
Cardiomyopaty, heart, diagnosis, treatment.
INTRODUCTION
A cardiomyopathy is a primary disorder of the heart
muscle. It is distinct from structural cardiac disorders
such as coronary artery disease, valvular disorders, and
congenital heart disorders. Cardiomyopathies are
divided into 3 main types based on the pathologic
features (see figure Forms of cardiomyopathy):
•
Dilated
•
Hypertrophic
•
Restrictive
The term ischemic cardiomyopathy refers to the
dilated, poorly contracting myocardium that can occur
in patients with severe coronary artery disease (with or
without areas of infarction). It is not classically
considered to be in the above-listed categories
Research Article
PREVENTION OF DILATED CARDIOMYOPATHY DISEASE MEASURES TO
TREAT IT
Submission Date:
December 04, 2023,
Accepted Date:
December 09, 2023,
Published Date:
December 14, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue12-03
Roxibjonov Adhamjon Raxmatjon O'g'li
Department Of Internal Medicine, Andijan State Medical Institute, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 12-2023
14
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
12
P
AGES
:
13-18
SJIF
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MPACT
FACTOR
(2021:
5.
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)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
because it does not describe a primary myocardial
disorder.
Manifestations of cardiomyopathies are usually those
of heart failure and vary depending on whether there
is systolic dysfunction, diastolic dysfunction, or both.
Some cardiomyopathies may also cause chest pain,
syncope, arrhythmias, or sudden death.
Evaluation typically includes family history, blood tests,
ECG, chest x-ray, echocardiography, and cardiac MRI.
Some patients require endomyocardial biopsy. Other
tests are done as needed to determine the cause.
Treatment depends on the specific type and cause of
cardiomyopathy
As a primary myocardial disorder, the myocardial
dysfunction of dilated cardiomyopathy occurs in the
absence of other disorders that can cause dilated
myocardium, such as severe occlusive coronary artery
disease or conditions that involve pressure or volume
overload of the ventricle (eg, hypertension, valvular
heart
disease).
In
some
patients,
dilated
cardiomyopathy is believed to start with acute
myocarditis (probably viral in most cases), followed by
a variable latent phase, a phase with diffuse necrosis of
myocardial myocytes (due to an autoimmune reaction
to virus-altered myocytes), and chronic fibrosis.
Regardless of the cause, the myocardium dilates, thins,
and hypertrophies in compensation (see figure Forms
of cardiomyopathy), often leading to functional mitral
regurgitation and/or tricuspid regurgitation and atrial
dilation.
The disorder affects both ventricles in most patients,
only the left ventricle (LV) in a few , and only the right
ventricle (RV) rarely.
Mural thrombi may form due to stasis of blood once
chamber dilation and dysfunction are significant.
Cardiac tachyarrhythmias often complicate the acute
myocarditis and late chronic dilated phases as may
atrioventricular block. Atrial fibrillation commonly
occurs as the left atrium dilates.
Dilated cardiomyopathy has many known and probably
many unidentified causes (see table Causes of Dilated
Cardiomyopathy). More than 20 viruses can cause
dilated cardiomyopathy; in
temperate zones,
coxsackievirus B is most common. In Central and South
America, Chagas disease due to Trypanosoma cruzi is
the most common infectious cause.
Other causes include prolonged (chronic) tachycardia,
HIV infection, toxoplasmosis, thyrotoxicosis, and
beriberi. Many toxic substances, particularly alcohol,
various organic solvents, iron or heavy metal ions, and
certain chemotherapeutic drugs (eg, doxorubicin,
trastuzumab), damage the heart. Frequent ventricular
ectopy (> 10,000 ventricular premature beats/day) has
been associated with left ventricular systolic
dysfunction.
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Publisher:
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Servi
Sudden emotional stress and other hyperadrenergic
states can trigger acute dilated cardiomyopathy that is
typically reversible (as is that caused by prolonged
tachycardia). An example is acute apical ballooning
cardiomyopathy
(also
called
takotsubo
cardiomyopathy, stress cardiomyopathy, or broken
heart syndrome). In this disorder, usually the apex and
occasionally other segments of the left ventricle are
affected, causing regional wall dysfunction and
sometimes focal dilation (ballooning).
Genetic factors play a role in 20 to 35% of cases; > 60
genes and loci have been implicated.
Onset of dilated cardiomyopathy is usually gradual
except in acute myocarditis, acute apical ballooning
cardiomyopathy,
and
tachyarrhythmia-induced
cardiomyopathy. About 25% of all patients with dilated
cardiomyopathy have atypical chest pain. Other
symptoms depend on which ventricle is affected.
Left ventricular dysfunction causes exertional dyspnea
and fatigue due to elevated left ventricular diastolic
pressure and low cardiac output.
Right ventricular failure causes peripheral edema and
neck vein distention. Infrequently the right ventricle is
predominantly affected in younger patients, and atrial
arrhythmias and sudden death due to malignant
ventricular tachyarrhythmias are typical.
•
Chest x-ray
•
ECG
•
Echocardiography
•
Cardiac MRI
•
Endomyocardial biopsy (select cases)
•
Testing for cause as indicated
Diagnosis of dilated cardiomyopathy is by history,
physical examination, and exclusion of other common
causes
of
ventricular
failure
(eg,
systemic
hypertension, primary valvular disorders, myocardial
infarction
—
see table Diagnosis and Treatment of
Cardiomyopathies). Particularly in cases of dilated
cardiomyopathy without a clear cause, a careful family
history should be taken to identify family members
with possible early-onset heart disease, heart failure,
or sudden death. In many centers, first-degree family
members are screened for cardiac dysfunction (such as
with echocardiography). Because other common
causes of ventricular failure must be excluded, chest x-
ray, ECG, echocardiography, and cardiac MRI are
required. Endomyocardial biopsy is done in selected
cases.
Serum cardiac markers are measured if acute
symptoms or chest pain is present. Although typically
indicative of coronary ischemia, troponin elevation
often occurs in heart failure, especially if renal function
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1121105677
Publisher:
Oscar Publishing Services
Servi
is decreased. Serum natriuretic peptide levels are
typically elevated when heart failure is present.
Specific causes suspected clinically are diagnosed (see
elsewhere in THE MANUAL). If no specific cause is
clinically apparent, serum ferritin and iron-binding
capacity and thyroid-stimulating hormone levels are
measured.
Serologic
tests
for
Toxoplasma,
T.
cruzi,
coxsackievirus, HIV, and echovirus may be done in
appropriate cases.
Chest x-ray shows cardiomegaly, usually of all
chambers. Pleural effusion, particularly on the right,
often accompanies increased pulmonary venous
pressure and interstitial edema.
The ECG may show sinus tachycardia and nonspecific
ST-segment depression with low voltage or inverted T
waves. Sometimes pathologic Q waves are present in
the precordial leads, simulating previous myocardial
infarction. Left bundle branch block and atrial
fibrillation are common.
Echocardiography shows dilated, hypokinetic cardiac
chambers and rules out primary valvular disorders.
Segmental wall motion abnormalities can also occur in
dilated cardiomyopathy because the process may be
patchy. Echocardiography may also show a mural
thrombus.
Cardiac MRI is increasingly done and is useful in
providing detailed imaging of myocardial structure and
function. MRI with gadolinium contrast may show
abnormal myocardial tissue texture or scarring pattern
(ie, late gadolinium enhancement, or LGE). The pattern
of LGE can be diagnostic in active myocarditis,
sarcoidosis, muscular dystrophy, or Chagas disease).
Positron-emission tomography (PET) has been shown
to be sensitive for diagnosis of cardiac sarcoidosis.
Coronary angiography may be required to exclude
coronary artery disease as the cause of LV dysfunction
when the diagnosis is in doubt after noninvasive tests.
Patients with chest pain or several cardiovascular risk
factors and older patients are more likely to have
coronary artery disease. Either ventricle can be
biopsied during catheterization in select cases where
the results will change management.
Endomyocardial biopsy is indicated if giant cell
myocarditis, eosinophilic myocarditis, or sarcoidosis is
suspected, as the results will affect management.
REFERENCES
1.
Mozimjon o’g’li, S. S.
, & Makhmudovich, A. H.
(2023). Causes of the Origin of Cardiovascular
Diseases and their Protection. AMALIY VA
TIBBIYOT FANLARI ILMIY JURNALI, 2(2), 185-
187.
Volume 03 Issue 12-2023
17
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
12
P
AGES
:
13-18
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
2.
Nozimjon o’g’li, S. S. (2022). INFORMATION
ABOUT THE STRUCTURE OF THE MEMBRANE
OF EPITHELIAL TISSUE AND GLANDS. British
Journal of Global Ecology and Sustainable
Development, 10, 65-69.
3.
Nozimjon o’g’li, S. S. (2022). Emergency
medical care in case of drowning and measures
to restore the patient's health. Academia open,
7, 10-21070.
4.
Nozimjon o
’g’li, S. S., & Xasanboy o’g’li, A. A.
(2021). Quantitative Indicators of Villi Cells in
the Intraepithelial Part of the Small Intestine.
EUROPEAN JOURNAL OF INNOVATION IN
NONFORMAL EDUCATION, 1(2), 19-21.
5.
Mahmudova, N. R., & Adkhamova, R. K. (2023).
FUNCTIONAL-SEMANTIC
PROPERTIES
OF
GRADATION. Ethiopian International Journal
of Multidisciplinary Research, 10(11), 42-43.
6.
Mahmudova, N. R., & Dadzhonova, S. S. (2023).
LINGUISTIC AND EXTRALINGUISTIC FEATURES
OF GRADATION. Ethiopian International
Journal of Multidisciplinary Research, 10(11),
52-53.
7.
Mahmudova, N. R. (2023). STATIC AND
DYNAMIC INDICATORS THAT REPRESENT
GRADATION IN ENGLISH AND UZBEK.
International Multidisciplinary Journal for
Research & Development, 10(10).
8.
Makhmudova, N. R. (2021). FUNCTIONAL-
SEMANTIC FIELD OF GRADUAL CATEGORY.
РОЛЬ ИННОВАЦИЙ В ТРАНСФОРМАЦИИ И
УСТОЙЧИВОМ РАЗВИТИИ СОВРЕМЕННОЙ,
87.
9.
Makhmudova, N. R. (2017). Comparative
analysis of the concept" woman" in English and
Uzbek proverbs. In Современная филология
(pp. 59-62).
10.
Sayfiyev, H., & Saidova, M. (2023). EFFECTS OF
GYMNASTICS ON FUNDAMENTAL MOTOR
SKILLS
(FMS),
POSTURAL
(BALANCE)
CONTROL, AND SELF-PERCEPTION DURING
GYMNASTICS TRAINING. Modern Science and
Research, 2(9), 204-210.
11.
Khairullayevich, S. H. Development of
gymnastics in Uzbekistan and attention to
gymnastics.
International
scientific-
educational
electronic
magazine"
OBRAZOVANIE I NAUKA, 21(12), 204-210.
12.
Xayrullayevich, S. H. (2023). Use of Acrobatic
Exercises and Their Terms In The Process of
Teaching Gymnastics. Intersections of Faith
and Culture: American Journal of Religious and
Cultural Studies (2993-2599), 1(9), 80-86.
13.
Saidova, M., & Sayfiyev, H. (2023). CONTENT-
IMPORTANCE AND PRINCIPLES OF PHYSICAL
EDUCATION CLASSES. Modern Science and
Research, 2(9), 192-199.
14.
Ayubovna, S. M., & Komiljonova, K. I. (2022).
Features of Application of Sports Games in
Volume 03 Issue 12-2023
18
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
12
P
AGES
:
13-18
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Preschool Children. International Journal of
Culture and Modernity, 16, 17-23.
15.
Saidova, M. (2023). THE CONCEPT OF
PHYSICAL QUALITIES. Modern Science and
Research, 2(10), 251-254.
16.
Sayfiyev, H., & Saidova, M. (2023). EFFECTS OF
GYMNASTICS ON FUNDAMENTAL MOTOR
SKILLS
(FMS).
POSTURAL
(BALANCE)
CONTROL, AND SELF-PERCEPTION DURING
gymnastics. International scientificeducational
electronic magazine" OBRAZOVANIE I NAUKA,
21.
17.
Ayubovna, S. M. (2023). Physiological Basics of
Forming Movement Skills and Teaching Sports
Techniques. Intersections of Faith and Culture:
American Journal of Religious and Cultural
Studies (2993-2599), 1(9), 87-94.
18.
CHULIEVA, V. E. (2021). THE PRINCIPLES OF
COMMONALITY AND SPECIFICITY IN THE
PHILOSOPHICAL TEACHINGS OF BAHA UD-DIN
WALAD
AND
JALAL
AD-DIN
RUMI.
THEORETICAL
&
APPLIED
SCIENCE
Учредители: Теоретическая и прикладная
наука, (9), 566
-573.
19.
Erkinovna, C. V. (2023). The Philosophical and
Mystical Views of Jaloliddin Rumi. EUROPEAN
JOURNAL OF INNOVATION IN NONFORMAL
EDUCATION, 3(1), 121-124.
20.
Chuliyeva, V. E. (2020). THE PROBLEM OF
PERSONALITY
IN
PHILOSOPHICAL
AND
ANTHROPOLOGICAL VIEWS OF BAHA AL-DIN
WALAD AND JALAL AD-DIN RUMI. Theoretical
& Applied Science, (11), 186-191.
