• Haq Nawaz
  • Rehan Ahmed
  • Nasir Ahmed
  • Abdul Rashid


Background: Dilated cardiomyopathy can lead to a variety of complications recognisable onclinical, echocardiographic, electrocardiographic and radiographic assessment. Among this,transthoracic echocardiography has the dual advantage of being helpful in making the diagnosis ofdilated cardiomyopathy as well as an effective tool in early recognition of certain complicationsfor timely management to improve the quality of life of these patients. Methods: This descriptive(case series) study was undertaken at Departments of Medicine, Cardiology, Paediatrics andObs/Gyn, Ayub Teaching Hospital, Abbottabad from July to December, 2008. Fifty patients ofdilated cardiomyopathy without age and gender discrimination were selected by conveniencesampling. Those with hypertrophic and restrictive cardiomyopathies, valvular and congenital heartdisease, hypertension and ischemic heart disease were excluded. Results: Mean age was47.12±17.9 year with male predominance (males=34, females=16). Mean ejection fraction was30.6±6.9%. Complications revealed on echocardiography were intracardiac thrombi (5, 10%),spontaneous echo contrast (5, 10%), pericardial effusion (6, 12%), mitral regurgitation (46, 92%),tricuspid (25, 50%), aortic (5, 10%), pulmonary (2, 4%) multi-valvular regurgitation (28, 56%),and left atrial dilatation (36, 72%). Conclusion: LV systolic dysfunction, cardiac thrombi,spontaneous echo contrast, mitral and tricuspid regurgitation and left atrial enlargement areimportant complications of dilated cardiomyopathy. Echocardiography is important tool towardsidentification of these complications.Keywords: cardiomyopathy, dilated, cardiomyopathy, complications, cardiomyopathy,congestive, echocardiography


Wynne J, Braunwald E. Cardiomyopathy and myocarditis. In:

Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL,

Jameson JL. (eds) Harrison’s Principles of Internal Medicine: 16th

ed. New York: The McGraw-Hill; 2005.p.1408–14.

Lavoie HM, Preston C. Cardiomyopathy, Dilated. [On line] 2005

July 7 last Up-date. [Cited 2006 December 15]: Available from:

Ahmad R, Awan ZA. An echocardiographic study of 129 cases of

cardiomyopathy. J Coll Physicians Surg Pak 1999;9:171–3.

Khan MA, Mohammad J, Hussain M. Frequency and

echocardiographic study of dilated cardiomyopathy in children

presenting with cardiac failure. Pak J Med Sci 2004;20:113–6.

Kadish A, Dyer A, Daubert JP, Quigg R, Anderson KP, Calkins

H, et al. Prophylactic defibrillator implantation in patients with

non-ischemic dilated cardiomyopathy. N Engl J Med


Sadiq M, Rathore AW, Younis M, Haider N, Masud F, Rehman

A. Thromboembolism in patients with myocarditis. Ann K E

Med Coll 2005;11:50–3.

Ahmad R, Awan ZA. A case series study of 26 subjects with left

ventricular thrombus to see its etiology and left ventricular

function. Pak J Med Sci 2004;20:51–4.

Ahmad R, Awan ZA. Atrial clots and their correlation with

various denominators: A study of 26 cases. Pak J Med Sci


Mas JL, Arquizan C, Lanny C, Zuber M, Cabanes L, Derumeaux

G, et al. Recurrent cerebrovascular events associated with patent

foramen ovale, atrial septal aneurysm or both. N Engl J Med


J Ayub Med Coll Abbottabad 2011;23(3) 55

Pengo V, Lensing AWA, Prins MH, Marchiori A, Davidson BL,

Tiozzo F, et al. Incidence of chronic thrombo-embolic pulmonary

hypertension after pulmonary embolism. N Engl J Med


Taylor MR, Carniel E, Mestroni L. Cardiomyopathy, familial

dilated. Orphanet J Rare Dis 2006;1:27–35.

Bashore TM, Granger CB. Heart. In: Tierney LM, McPhee SJ,

Papadakis MA. Current Medical Diagnosis & Treatment 45th ed.

California: McGraw-Hill: 2006:p. 400–2.

Dec G.W, Fuster V. Idiopathic dilated cardiomyopathy. N Engl J

Med 1994;331:1564–75.

Napporn AG, Kane A, Damorou JM, Dia AA, Diop IB, Sarr M, et

al. Intraventricular thrombosis complicating peri-partum

idiopathic myocardiopathy. Ann Cardiol Angeiol (Paris)


Mc Crindle BW, Karamlou T, Wong H, Gangam N, Trivedi KR,

Lee KJ, et al. Presentation, management and outcomes of

thrombosis for children with cardiomyopathy. Can J Cardiol


Kumar H. Incidence of intracavitary thrombus in dilated

cardiomyopathy. J Assoc Physicians India 1994;42:753–4.

Mazzone M, La Sala M, Portale G, Ursella S, Forte P, Carbone L,

et al. Review of dilated cardiomyopathies: Dilated

cardiomyopathies and altered prothrombotic state: a point of view

of the literature. Panminvera Med 2005;47:157–67.

Falk RH, Foster E, Coats MH. Ventricular thrombi and

thromboembolism in dilated cardiomyopathy: a prospective

follow-up study. Am Heart J 1992;123:136–42.

Blondheim DS, Jacobs LE, Kotler MN, Costacurta GA, Parry

WR. Dilated cardiomyopathy with mitral regurgitation: decreased

survival despite a low frequency of left ventricular thrombus. Am

Heart J 1991;122:763–71.

Siostrzonek P, Koppensteiner R, Gossinger H, Zangeneh M,

Heinz G, Kreiner G, et al. Hemodynamic and hemorheologic

determinants of left atrial spontaneous echo contrast and thrombus

formation in patients with idiopathic dilated cardiomyopathy. Am

Heart J 1993;125:430–4.

Tramarin R, Torbicki A, Franchini M, Forni G, Febo O, Gibellini

R, et al. Transoesophageal echocardiography in the definition of

intracardiac sources of emboli in patients with recent ischemic

stroke. G Ital Cardiol 1990;20:713–9.

Dall’Aglio V, Nicolosi GL, Zanuttini D. Transthoracic and

transoesophageal echocardiographic documentation of

disappearance of massive right atrial and pulmonary artery

thromboemboli after fibrinolytic therapy and normalization of left

ventricular dimensions and function. Eur Heart J 1990;11:863–5.

Shen WF, Tribouilloy C, Rida Z, Peltier M, Choguet D, Rey JL,

et al. Clinical significance of intracavitary spontaneous echo

contrast in patients with dilated cardiomyopathy. Cardiology


Afridi HR, Hartnell GG. Cardiomyopathy, dilated. [On line] 2005

February 10 last up-date. [Cited 2008 December 15]: Available

from: URL:

Touze JE, Mouanodji G, Mardelle T, Akani F, Ekra A, Bertrand

E. Primary congestive cardiomyopathies of the adult in a tropical

environment: nosologic, diagnostic and developmental data. Med

Trop (Mars) 1987;47:95–9.

Luthra A. (editor) Echo made easy. 1st ed. New-Dehli: Jaypee

Brothers Medical Publishers; 2005.p.77–83.

Venturi F, Gianfaldoni ML, Melina G, Cecchi A, Petix NR,

Monopoli A, et al. Mitral effective regurgitant orifice area versus

left ventricular ejection fraction as prognostic indicators in patients

with dilated cardiomyopathy and heart failure. Ital Heart J


Diaz RA, Nihoyannopoulos P, Oakley CM. Valvular insufficiency

in dilated cardiomyopathy diagnosed by color Doppler

echocardiography. Rev Med Chil 1989;117:1232–5.




Most read articles by the same author(s)

1 2 > >>