Causes of Dilated Cardiomyopathy
Cause | Examples |
|---|---|
Chronic tachycardia | Frequent ventricular ectopy Uncontrolled atrial fibrillation or other persistent tachyarrhythmias |
Eosinophilic myocarditis | |
Genetic abnormality | Familial disease in 30–40% of patients: autosomal dominant, X-linked, autosomal recessive, mitochondrial inheritance, or polygenic |
Granulomatous disorders | Granulomatosis with polyangiitis Granulomatous or giant cell myocarditis |
Hereditary neuromuscular and neurologic disorders | Dystrophinopathies (Duchenne/Becker muscular dystrophy/X-linked DCM) Emery-Dreifuss muscular dystrophy Fascioscapulohumeral muscular dystrophy Limb-girdle muscle dystrophies Myotonic dystrophy |
Infections (acute or chronic) | Bacterial (eg, brucellosis, diphtheria, psittacosis, typhoid fever) Fungal Helminthic Protozoal (eg, Chagas disease, schistosomiasis, toxoplasmosis) Rickettsial Spirochetal (eg, borreliosis, leptospirosis) Viral (eg, adenovirus, coronavirus [including COVID-19], coxsackievirus A, coxsackievirus B, cytomegalovirus, Epstein-Barr virus, human herpes virus 6, hepatitis B virus, hepatitis C virus, HIV, influenza A, influenza B, parvovirus B19, varicella) |
Medications, drugs, and toxins | Amphetamines Anthracyclines Carbon monoxide Catecholamines Cocaine Cyclophosphamide Doxorubicin Heavy metals (cobalt, lead, mercury) Organic solvents Psychotherapeutic medications (tricyclic and quadricyclic antidepressants, phenothiazine) Radiation Trastuzumab |
Metabolic disorders/endocrinopathies | Electrolyte disturbances (hypocalcemia, hypophosphatemia, uremia) Endocrine abnormalities (Cushing disease, acromegaly, hypothyroidism, hyperthyroidism) Nutritional deficiencies (thiamine, carnitine, selenium, kwashiorkor) Iron overload (hereditary hemochromatosis and secondary iron overload) |
Pregnancy (peripartum period) | — |
Systemic rheumatic diseases | |
Tumors | Certain endocrinologically active tumors (eg, pheochromocytoma, paraganglioma, adrenal tumors, thyroid tumors) |
Heymans S, Lakdawala NK, Tschöpe C, Klingel K. Dilated cardiomyopathy: causes, mechanisms, and current and future treatment approaches. Lancet. 2023;402(10406):998-1011. doi:10.1016/S0140-6736(23)01241-2; Japp AG, Gulati A, Cook SA, Cowie MR, Prasad SK. The Diagnosis and Evaluation of Dilated Cardiomyopathy. J Am Coll Cardiol. 2016;67(25):2996-3010. doi:10.1016/j.jacc.2016.03.590; Schultheiss HP, Fairweather D, Caforio ALP, et al. Dilated cardiomyopathy. Nat Rev Dis Primers. 2019;5(1):32. doi:10.1038/s41572-019-0084-1; Tayal U, Ware JS, Lakdawala NK, Heymans S, Prasad SK. Understanding the genetics of adult-onset dilated cardiomyopathy: what a clinician needs to know. Eur Heart J. 2021;42(24):2384-2396. doi:10.1093/eurheartj/ehab286 | |
