Dilated Cardiomyopathy

Associated with hypertrophy, dilatation and systolic dysfunction of heart

Causes:

Alcohol

Doxorubicin

Peripartum

Duchenne muscular dystrophy

Viral infection have also been implicated

Alteration in genes for desmin, B myosin and troponin have also been implicated

Gross – dilatation, >900 gms, stasis causing mural thrombi endocardial fibrosis, normal valves and coronary arteries

Microscopic – myocyte hypertrophy, myofibrillar loss and interstitial fibrosis with monocyte infiltration

Clinical significance – heart failure and susceptibility to lethal ventricular arrythmia

Treatment: number one indication for heart transplant

Dilated cardiomyopathy

Cardiomyopathy – loss of myofibrils

Cardiomyopathy – trichrome stain showing extensive fibrosis (blue) between

the myocytes. The myocytes also vary in size, and some have partial loss of

myofibrils.

Cardiomyopathy – loss of fibrils and a small contraction band in the top center.