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Dilated Ischemic Cardiomyopathy

Beta Blockers, Cardiomyopathy, Defibrillator, Heart Transplant

Working in a Cardiology office I have seen this condition a few times. Three cases stick with me and each chose person chose a different path. I will touch on each briefly below.

What is Dilated Ischemic Cardiomyopathy

This is a condition whereby the heart enlarges and has to work harder to pump blood throughout the body. The walls of the heart also become thinner and the risk for a blood clot is elevated.

How does a person develop this condition?

There is no definite answer for this question. It is thought that this condition may be hereditary. There are studies being done to determine if this is a factor in a person having this condition. The truth is no one knows for sure how a person develops this type of cardiomyopathy.

What symptoms does a patient get?

A patient with this type of cardiomyopathy may have weakness and fatigue. This is a direct result of the heart working harder than it was meant too. There might be dizziness also. When the heart gets too weak to pump effectively, then a patient will have congestive heart failure which means fluid in the lungs. This will cause ankles and legs to swell and shortness of breath.

What treatments are used?

There are two options known to treat this condition. One would be treating the symptoms with medication. The type of medications are in a class of drugs called beta blockers or vasodilators. Beta blockers control blood pressure, hence putting less strain on the heard. Some beta blockers treat any water retention which helps in those who have developed congestive heart failure. They also act as a diuresis to get rid of any water build up in the legs and ankles. Vasodilators also help to lower blood pressure and also to get the arteries to open up and let blood pass through.

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The second option would be to control the symptoms a patient is experiencing with medication but at the same time they sign up to be on a Heart Transplant List. Dilated ischemic cardiomyopathy is the reason why most people need a heart transplant.


Because the heart is beating harder while getting weaker, some patients will develop cardiac arrhythmias which are irregular heartbeats. In these cases the doctor will recommend insertion of an implantable cardioverter defibrillator which is abbreviated as (ICD). This defibrillator will control the heart’s beating and will help the heart to beat in a regular rhythm.

The three patients I alluded to above each chose a different path but all passed away in a relatively short time. A female patient declined a heart transplant but changed her mind and it was too late. She was already debilitated and could not have survived surgery. The second, a male patient was treated with medication while he was on a transplant list. For him, a heart became available but he had learned a 15 year old boy was a match for the heart too. He gave up that heart and passed away before a another heart became available for him. The third patient was male. He went on medication and did not want a transplant. The last time I saw him was on a 4th of July. I asked him to lay down and unbutton his shirt so I could perform an electrocardiogram. As I turned around with the electrodes, I noticed he had a sticker of a flag over his heart. We both laughed and that was the last time I saw him as he passed away shortly after.

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