An Etiological Study of Dilated Cardiomyopathy in Correlation with Clinical, ECG And Echocardiographic Profile

Cardiomyopathy is a primary disorder of the heart muscle that causes abnormal myocardial performance and is not the result of disease or dysfunction of other cardiac structures. Dilated cardiomyopathy is the most common variety of cardiomyopathy. Other types of cardiomyopathy are hypertrophic and restrictive cardiomyopathy. Dilated cardiomyopathy represents the final common pathway produced by a variety of ischaemic, toxic, metabolic and immunological mechanisms damaging the heart muscle. The incidence of DCM is reported to be 5 to 8 cases per 1,00,000 population per year. DCMP is more common in male and blacks. Natural history of DCM is not well established. The patient can present with variable symptoms like heart failure, arrhythmias, stroke or sudden death. Some may have minimal or no symptoms. The present study aims to evaluate the etiological, electrocardiographical, echocardiographical and clinical profile of DCMP patients. The present study is one year cross sectional study on patients admitted in the department of Medicine, RIMS Ranchi. Patient was included based on Clinical and Echocardiographic criteria while those with Valvular and Congenital heart disease were excluded. Statistical analysis was done with percentage, proportions, chi-square and correlation. The results of this study showed majority of patients were males compromising 56.6% and females were 43.25%. In males DCMP was mostly seen in elderly while in females it was mostly seen in middle age. The most common etiology was ischaemic DCMP comprising 33.3% patients, followed by diabetic, peripartum, idiopathic and alcoholic. The most common presentation in our study was biventricular failure which was seen in 80% of cases followed by isolated Left ventricular failure. Majority of patients were in NYHA class IV and III. Other symptoms were cough, easy fatiguability, pedal edema, abdominal pain, palpitation, chest pain and syncope. ECG findings included QRS axis deviation (left and right), ventricular ectopics, sinus tachycardia, LBBB, RBBB, AF, atrial ectopics, SVT, VT, CHB, LVH and nonspecific ST-T changes. Echocardiographic findings included reduced LV ejection fraction, MR, TR, LV clot and pericardial effusion. Chest radiography findings included increased cardiothoracic ratio, pleural effusion and pulmonary plethora. Conclusion of the study included most common type is DCMP, most common etiology is ischaemic and most common clinical presentation is biventricular failure. The most common ECG findings were sinus tachycardia and ventricular ectopics. In Echocardiography most common finding was reduced Left ventricular ejection fraction.