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Dilated cardiomyopathy is the most common form of cardiomyopathy. It generally occurs in adults aged 20 to 60 years. Men are more likely than women to develop dilated cardiomyopathy.

Dilated cardiomyopathy affects the heart's ventricles (VEN-trih-kuls) and atria. The ventricles are the two lower chambers of the heart, and the atria are the two upper chambers. Dilated cardiomyopathy usually starts in the left ventricle, where the heart muscle begins to dilate or stretch and become thinner. This leads to enlargement of the inside of the ventricle. The problem often spreads to the right ventricle and then to the atria as the disease gets worse.

When the chambers dilate, the heart can't pump blood very well. The heart tries to cope by dilating the chambers even more. Over time, the heart becomes weaker and heart failure can occur. Symptoms of heart failure include feeling tired, swelling of the legs and feet, and shortness of breath. Dilated cardiomyopathy also can lead to heart valve problems, arrhythmias, and blood clots in the heart. Having advanced dilated cardiomyopathy is a common reason for needing a heart transplant.

Up to one-half of all cases of dilated cardiomyopathy may be hereditary (passed down in the genes from parent to child). These cases are called familial dilated cardiomyopathy. Dilated cardiomyopathy also can be a complication of many conditions, including coronary artery disease and high blood pressure. It also can be caused by viral infections, excessive use of alcohol, and exposure to certain drugs (including cocaine, amphetamines, and some drugs used in cancer treatments). In some cases, no cause can be found.