Here is a patient with class 3 dyspnea who was referred for echocardiography
Right ventricular dysfunction is major determinant of clinical outcome in patients with dilated cardiomyopathy. The myocardium of the entire heart is now known to be a single sheet of muscle rolled into different chambers . So any primary disease of myocardium will involve the entire musculature . This is the reason , all the 4 chambers of heart goes for dilatation in primary cardiomyopathy . Of course there can be minor variations due to differential hemodynamic impact.
But it is certain , RV function will definitely be compromised In most patients with Idiopathic DCM (Less common in Ischemic DCM ) Rapid assessment of RV function is difficult . Of course We have some clues .
2 d Features
- Simple dilatation of RV is suffice to say it is struggling with the loading conditions
- Septal bowing
- Tricuspid annular dilatation
- RV ejection fraction (Continues to be complex for routine usage )
- Morphology may be useful (Mainly for TR severity )
- RV strain rate Imaging etc.