Dilated cardiomyopathy is a progressive disease of heart muscle that is characterized by

ventricular chamber enlargement and contractile dysfunction with normal left ventricular (LV) wall
thickness. The right ventricle may also be dilated and dysfunctional. Dilated cardiomyopathy is the
third most common cause of heart failure and the most frequent reason for heart transplantation.Dilated
cardiomyopathy is 1 of the 3 traditional classes of cardiomyopathy, along with hypertrophic and
restrictive cardiomyopathy. However, the classification of cardiomyopathies continues to evolve, based
on the rapid evolution of molecular genetics as well as the introduction of recently described diseases.
Multiple causes of dilated cardiomyopathy exist, one or more of which may be responsible for an
individual case of the disease (see Etiology). All alter the normal muscular function of the myocardium,
which prompts varying degrees of physiologic compensation for that malfunction. The degree and time
course of malfunction are variable and do not always coincide with a linear expression of symptoms.
Persons with cardiomyopathy may have asymptomatic LV systolic dysfunction, LV diastolic
dysfunction, or both. When compensatory mechanisms can no longer maintain cardiac output at normal
LV filling pressures, the disease process is expressed with symptoms that collectively compose the
disease state known as chronic heart failure (CHF).Continuing ventricular enlargement and dysfunction
generally leads to progressive heart failure with further decline in LV contractile function. Sequelae
include ventricular and supraventricular arrhythmias, conduction system abnormalities,
thromboembolism, and sudden death or heart failurerelated death. Cardiomyopathy is a complex
disease process that can affect the heart of a person of any age, but it is especially important as a cause
of morbidity and mortality among the world's aging population. It is the most common diagnosis in
persons receiving supplemental medical financial assistance via the US Medicare program.
Nonpharmacologic interventions are the basis of heart failure therapy. Instruction on a sodium diet
restricted to 2 g/day is very important and can often eliminate the need for diuretics or permit the use of
reduced dosages. Fluid restriction is complementary to a low-sodium diet. Patients should be enrolled
in cardiac rehabilitation involving aerobic exercise.()http://emedicine.medscape.com/article/152696overview#a0101

The true incidence of cardiomyopathies is unknown. As with other diseases, authorities

depend on reported cases (at necropsy or as a part of clinical disease coding) to define the prevalence
and incidence rates. The inconsistency in nomenclature and disease coding classifications for
cardiomyopathies has led to collected data that only partially reflect the true incidence of these
diseases. Whether secondary to improved recognition or other factors, the incidence and prevalence of
cardiomyopathy appear to be increasing. The reported incidence is 400,000-550,000 cases per year,
with a prevalence of 4-5 million people. Cardiomyopathy is a complex disease process that can affect
the heart of a person of any age, and clinical manifestations appear most commonly in the third or
fourth decade.
Full reliable data on the incidence and prevalence of dilated cardiomyopathy are not
available. In the United States, at least 0.7% of cardiac deaths are attributable to cardiomyopathy.
Dilated cardiomyopathy probably contributes the great majority of these cases. The mortality rate for
cardiomyopathy in males is twice that of females, and for blacks it is 2.4 times that of whites.
Cardiomyopathy was diagnosed in 0.67% of patients discharged from hospitals in 1979 with diagnoses
of disease of the circulatory system. Cardiomyopathy accounted for 1% of general cardiologists' and
for 7% of academic cardiologists' patient encounters.In Scandinavia, population surveys suggested an
annual incidence of dilated cardiomyopathy ranging from 0.73 to 7.5 cases per 100,000 population; for
Tokyo this figure is 2.6. The prevalence of cardiomyopathy in underdeveloped and in tropical countries
is
considerably
higher
than
in
developed
countries
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2418518/