Francisco Javier Sanchez Reyes
Dilated cardiomyopathy is defined by the presence of a dilated left ventricle (LV) with systolic dysfunction in the absence of a hemodynamic cause that can produce the existent dilation and dysfunction. The incidence of dilated cardiomyopathy are estimate in United States at 1.1 cases per 100 000 person-years in children under 20 years, with an incidence of 8.3 cases per 100 000 person-years in children under 1 year old. Are more common in male. About the half of the cases under 20 years old patients that have dilated cardiomyopathy (DCM), between the 10% to 25% of cases is associated to acute myocarditis. Also this kind of pathologys have an elevated mortality.
About the pathogenetic causes of dilated cardiomyopathy categories it can be;
primary (idiopathic, familial/genetic mutations) secondary (inflammatory, viral, immunity diseases, toxin associated, metabolic disorders, fatty acid oxidation disorders, glycogen storage diseases {type II y IV}, lyposomal store disorders, nutritional disorders, structural heart diseases, pulmonary diseases) )The idiopathic causes is the most common that can reach up to the 70%.
The pathophysiology of dilated cardiomyopathy makes that approximately 1/3 of the myocardial cels presents apoptosis or necrosis with compensatory hypertrophy, with pathology remodelation of the heart, with growth of the miocardiac mase, ventricular dilation and slim of the ventricular walls.