WHAT YOU NEED TO KNOW:

What is dilated cardiomyopathy? Dilated cardiomyopathy (DCM) develops when one or both ventricles (lower chambers of your heart) are damaged and become enlarged. The enlarged ventricles are too weak to pump blood to your body.

What increases my risk for DCM?

• Family history of DCM
  
  
• Conditions that cause heart damage, such as coronary artery disease
  
  
• Infections such as HIV or toxoplasmosis
  
  
• Alcohol or drug abuse
  
  
• Long-term conditions, such as diabetes, hypothyroidism, autoimmune disorders, or sleep apnea
  
  
• Medicines such as chemotherapy or antivirals

What are the signs and symptoms of DCM?

• Coughing, wheezing, or trouble breathing
  
  
• Increasing fatigue and weakness
  
  
• Swelling in your legs, ankles, or fingers
  
  
• Feeling of fullness and no appetite
  
  
• Unexplained weight gain
  
  
• Fast or fluttering heartbeat

How is DCM diagnosed?

• An x-ray or MRI will show the size and thickness of your ventricles and if your heart is enlarged. If you have an MRI, you may be given dye to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
  
  
• An echocardiogram uses sound waves to take pictures of your heart. The pictures show the size of your ventricles, and how well they are pumping blood.
  
  
• Cardiac catheterization is a procedure used to see inside your heart and its blood vessels. X-rays and dye injected into your heart's blood vessels allow your healthcare provider to see blood move through your heart. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.

What medicines are used to treat DCM?

• Diuretics help your body release fluid that has built up.
  
  
• Blood pressure medicines lower your blood pressure and improve blood flow through your heart.
  
  
• Heart medicines help regulate your heart rhythm and strengthen your heartbeat.
  
  
• Blood thinners

  help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:

  • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
    
    
  • Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
    
    
  • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    
    
  • Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
    
    
  • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin.
    • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      
      
    • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.

What other treatments might I need?

• Cardiac rehab is a program that will help you safely strengthen your heart. This plan includes exercise, relaxation, stress management, and heart-healthy nutrition instructions. Healthcare providers will make sure your medicines are helping to reduce your symptoms.
  
  
• A surgically implanted device, such as a pacemaker or ventricular assist device (VAD), may be placed in your chest. The device may regulate your heartbeat or help your heart pump blood to your body.
  
  
• Surgery may be done to treat other conditions and reduce your symptoms.

How do I manage my DCM?

• Weigh yourself every morning. Use the same scale, in the same spot. Weigh yourself after you use the bathroom, but before you eat or drink anything. Wear the same type of clothing each day. Do not wear shoes. Keep a record of your daily weights so you will notice sudden weight gain. Bring the record to appointments with your healthcare providers. Swelling and weight gain are signs of fluid retention. If you are overweight, ask your healthcare provider how to lose weight safely.
  
  
• Eat heart-healthy foods and limit sodium (salt). Eat more fresh fruits and vegetables and fewer canned and processed foods. Replace butter and margarine with heart-healthy oils such as olive oil and canola oil. Other heart-healthy foods include walnuts, fatty fish such as salmon and tuna, whole-grain breads, low-fat dairy products, beans, and lean meats. You may need to eat less than 2 grams of salt per day. Do not use salt substitutes. Ask your healthcare provider for more information on heart-healthy and low-salt diets.
  
  
• Limit alcohol. Alcohol weakens your heart. Ask your healthcare provider if it is safe for you to drink any alcohol. If it is safe, talk to him about how much alcohol is safe for you.
  
  
• Do not smoke. If you smoke, it is never too late to quit. Smoking weakens your heart and makes shortness of breath and other symptoms worse. Ask your healthcare provider for information if you need help quitting.
  
  
• Manage other health conditions. Diabetes, sleep apnea, and other heart conditions can put more stress on your heart if not managed.

When should I contact my healthcare provider?

• You have more trouble breathing while you do your daily activities or exercise.
  
  
• You have new swelling in your legs, ankles, or fingers.
  
  
• You gain 2 or more pounds in a day.
  
  
• You have constant pain or fullness in your abdomen, or you lose your appetite.
  
  
• You have questions or concerns about your condition or care.

When should I or someone else seek immediate care or call 911?

• You have any of the following signs of a heart attack:
  • Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or returns
    
    
  • Discomfort or pain in your back, neck, jaw, stomach, or arm
    
    
  • Trouble breathing
    
    
  • Nausea or vomiting
    
    
  • Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing
  
  
• You have any of the following signs of a stroke:
  • Numbness or drooping on one side of your face
    
    
  • Weakness in an arm or leg
    
    
  • Confusion or difficulty speaking
    
    
  • Dizziness, a severe headache, or vision loss
  
  
• You cough up blood.
  
  
• You are weak, sweaty, or pale, with cold feet or hands.
  
  
• You lose consciousness.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.