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the body which fails to meet the body’s demand. This is known as heart failure. There can be a build up of fluid in the lungs and under the skin, which can cause breathlessness and swelling of the legs and abdomen.


We can find a specific cause for DCM in about half of patients. In the other half, however, the cause remains uncertain. The commonest causes of DCM in the western world include coronary artery disease (‘furring’ of arteries to the heart), which may lead to reduced blood flow to the heart muscle and a weak heart. Other common causes include longstanding high blood pressure, excessive alcohol intake and heart valve disease. Less common causes include viral infections, autoimmune diseases (i.e. the body’s own defences mistakenly attack the heart muscle cells, resulting in damage to the heart muscle), deficiency of several vitamins and other rare conditions.


Pregnancy There is a form of DCM, known as ‘post-partum cardiomyopathy’, which develops during late pregnancy and in the period shortly following childbirth. The cause is uncertain, but it is believed that the extra strain of pregnancy on the heart may trigger the development of the condition.


Genetics In at least 40% of people with DCM in whom no other cause can be found, other family members can show signs of it and it has therefore been inherited. Currently, we can explain a quarter of inherited DCM by finding the underling genetic problem (mutation). This does require testing for many different genes which is rarely done because of the expense. One gene, Lamin AC, is often tested for because it is found most commonly and can be associated with a higher risk of arrhythmia.


What are the symptoms? Your symptoms can depend upon how severe the condition is, but you may suffer none at all yet still carry signs of DCM. • Shortness of breath is common and can become worse with exertion. When severe, it can be present at rest or even when you lie flat in bed which may wake you up at night. You may feel more comfortable sitting-up in bed by adding extra pillows.


• Lack of energy and tiring easily. • Ankle swelling, called oedema, which can worsen to affect the thighs, back and abdomen.


• Palpitations can occur and means that you are aware of your heartbeat due to an abnormal heart rhythm. The heart can either beat irregularly, too rapidly (tachycardia) or too slowly (bradycardia).


• Dizziness or blackouts.


Cardiac Risk in the Young


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