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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.