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What Are the Signs & Symptoms of Diabetic Cardiomyopathy?

Diabetic cardiomyopathy is enlargement and dysfunction of the ventricle (lower chamber) of the heart. Signs and symptoms of diabetic cardiomyopathy are related to heart failure. Enlargement of the heart develops in diabetics in the absence of other risk factors such as high blood pressure, which is a common risk factor for cardiomyopathy. There may be no other signs of heart disease. Diabetic cardiomyopathy signs and symptoms may not be present until late in the disease.

  1. Features

    • Diabetes affects the structure of the heart at a cellular level. The exact mechanism is not completely understood, but the ventricle of the heart becomes fibrous or "stiff," affecting the ability of the heart to pump effectively. Diabetic cardiomyopathy develops specifically among diabetics, perhaps from dysfunction of lipid metabolism. Diabetic cardiomyopathy is common in both type 1 and type 2 diabetics.

    Significance

    • The incidence of diabetes is increasing -- as diabetes increases from rising rates of obesity and inactivity, so will the incidence of diabetic cardiomyopathy and heart failure. Seventy-five percent of diabetics die from some form of heart disease.

    Symptoms

    • Signs and symptoms of diabetic cardiomyopathy may be absent. Congestive heart failure symptoms include shortness of breath, swelling in the abdomen or lower extremities and intolerance to exercise. Fluid that accumulates in the chest because of the decreased ability of the heart to pump effectively may lead to chest congestion and cough, in addition to feelings of pressure in the chest.

    Prevention/Solution

    • Intense control of blood sugar levels is believed to be one of the only ways to prevent diabetic cardiomyopathy that leads to heart failure. Statin drugs are being explored but do not completely address the mystery that surrounds the development of diabetic cardiomyopathy. It is likely that the condition develops from complex factors related to dysfunctional metabolic issues. Diabetes and high blood pressure are the leading causes of heart failure.

    Theories/Speculation

    • Diabetic cardiomyopathy is common. Suspicion of enlarged heart is suggested even among people who are pre-diabetic because of its prevalence. Albumin found in the urine of diabetics during a routine urinalysis is considered a risk factor for diabetic cardiomyopathy.

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