1. What is dilated cardiomyopathy? Dilated cardiomyopathy has a slow onset and can develop at any age, and it is more common at the age of 30-50 years old. It is mainly characterized by the enlargement of the heart and the reduction of the heart’s contractile function, which cannot normally transport blood to the whole body. The main manifestations are chest tightness and shortness of breath, palpitations, fatigue, dyspnea, abdominal distension and edema. Echocardiography shows obvious enlargement of heart chambers, electrocardiogram shows diverse and changeable arrhythmias, ST-T changes, etc. 2.What is the incidence of cardiomyopathy? In recent years, the prevention and treatment of hypertension, coronary heart disease, valvular disease and other cardiovascular diseases have been emphasized, but many people do not know that cardiomyopathy is also a serious health hazard. According to some hospitals and local statistics, cardiomyopathy in our country hospitalized cardiovascular disease patients accounted for about 15%, the population incidence rate of about 1/10000, which is projected to have more than 120,000 patients with cardiomyopathy. The mortality rate of cardiomyopathy is very high, and the mortality rate of dilated cardiomyopathy is as high as 35% in 5 years. 3.What is the classification of dilated cardiomyopathy? Primary cardiomyopathy (idiopathic dilated cardiomyopathy): relatively common. Ischemic dilated cardiomyopathy: mostly caused by long-term chronic myocardial ischemia or ventricular remodeling after acute infarction. Most common and has a worse prognosis than non-ischemic cardiomyopathy. Secondary cardiomyopathy Hypertensive (dilated) cardiomyopathy: better prognosis than others. Valvular (dilated) cardiomyopathy: some improvement with treatment of the primary disease. Anthracycline cardiomyopathy, perinatal cardiomyopathy, etc. 4. Who should suspect cardiomyopathy? Patients with family history of dilated cardiomyopathy, chronic myocarditis, recurrent colds, herpes zoster, hepatitis B; or long-term chronic myocardial ischemia, myocardial infarction; or long-term hypertension; or valvular disease, patients with chest tightness and shortness of breath, palpitations, fatigue, cough, double lower extremity edema, arrhythmia, etc., should be suspected of dilated cardiomyopathy when four or more symptoms appear. The symptoms of dilated cardiomyopathy should be suspected when there are four or more symptoms. 5.What are the characteristics of dilated cardiomyopathy? Secondary dilated cardiomyopathy, especially post-infarction cardiomyopathy or valvular cardiomyopathy, because of the cause of the primary disease, it is easy to find; and hypertensive or primary dilated cardiomyopathy is more insidious, because the cause of the primary disease is not clear and the symptom is not obvious, it is not easy to find out in the early stage, and a lot of patients are in the physical examination and find out that they may have cardiomyopathy. This kind of cardiomyopathy may not have any special performance in the early stage, and special symptoms, such as fatigue, will appear only during physical activities. With the progress of the disease will appear some mild heart failure manifestations such as cough, chest tightness, etc., in this period of time some patients are not too easy to be detected, many people usually do not go to the doctor, with the further aggravation of heart failure will be completely heart failure symptoms such as dyspnea, can’t sleep flat on the ground, need to put up pillows or semirecumbent position, puffiness (chest and legs), easy to fatigue and so on. More than 80% of cardiomyopathy patients can be accompanied by arrhythmia, such as premature beats, atrial fibrillation, conduction block, etc. Arrhythmia can lead to sudden death of the patient when it is serious, so early detection and early treatment of cardiomyopathy is very important. 6.Dilated cardiomyopathy and age have a relationship? Is it more common in the elderly? Generally speaking, the elderly may have more factors that trigger and aggravate the heart load, so the incidence of secondary cardiomyopathy is higher than that of young people. However, dilated cardiomyopathy does not have a strong relationship with age, especially primary cardiomyopathy. Some people think that they are young and won’t get heart disease, in fact, the incidence of cardiomyopathy does not distinguish between age and size, but it is still predominant in young and middle-aged men. 7, dilated cardiomyopathy of western medical treatment characteristics and problems? Western medicine treatment of heart failure, in recent years there has been a great development, its advantages: (1) drugs cardiotonic diuretic, vasodilator drugs, B receptor blockers, angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor antagonists and other applications. (2) Heart failure pacing therapy Mainly used for severe bradycardia and ventricular electrical activity asynchrony, which can improve cardiac function and reduce mitral regurgitation. (3) Cardiac surgical treatment Heart transplantation, cardiomyoplasty, and so on. Nevertheless, western medicine is still unclear about the etiology and mechanism of primary cardiomyopathy, and the conventional treatment for patients with advanced cardiomyopathy can only alleviate the symptoms and slow down the process of heart failure, but not give a satisfactory treatment. 8.What are the characteristics of Chinese medicine treatment of cardiomyopathy? Advantages of Chinese medicine treatment: In recent years, it is gradually recognized that primary cardiomyopathy is closely related to viral infection and immune malfunction. And Chinese medicine has traditionally held certain advantages in the treatment of anti-virus and immune regulation. (1) Chinese medicine emphasizes a holistic view, which can improve the quality of patient’s survival, effectively reduce symptoms, improve palpitations and fatigue, chest tightness, abdominal distension, sweating, insomnia, depression, and lumbar and knee soreness, etc., and reduce exogenous infections by improving immunity. (2) Eliminate the side effects of western medicines, such as betalactam dosage adjustment, usually starting from a small amount. Increase the dosage once in two weeks, and it takes two months to adjust to the target dosage. If the incremental rate is fast, the patient will experience fatigue and severe bradycardia which cannot be tolerated. If the adjustment is slow, the patient’s treatment time is often delayed. Combined Chinese and Western medicine treatment can shorten the time of adjusting the dose once every two weeks to seven days, and in some cases, the dose is incremented once every three days, and there are no obvious side effects, which can buy time for the patient’s early recovery, stabilization of the condition, and reduction of sudden death. (3) There is no western medicine forbidden area, such as heart failure with renal insufficiency or hypotension, ACEI drugs are restricted. Heart failure with bronchial asthma or severe intraventricular block, atrioventricular block and severe sinus bradycardia, β-blockers are restricted, heart failure with low potassium digitalis is restricted. Traditional Chinese medicine is not obviously prohibited. (4) myocardial fibrosis treatment, chronic heart failure after dilated cardiomyopathy is also a serious stage of myocardial fibrosis, whether through effective treatment, to prevent its progression and even reversed to the normal state, is the key to our treatment of dilated cardiomyopathy. Our previous research project: “Research on myocardial fibrosis in the chronic stage of viral myocarditis by traditional Chinese medicine Compound Cardiomyocardium Kang” has achieved expected results, confirming that traditional Chinese medicine can intervene in the process of heart failure through anti-myocardial fibrosis, and the research was awarded the First Prize of Scientific and Technological Achievements by Henan Provincial Department of Education. 9.How to prevent dilated cardiomyopathy? The cause of primary cardiomyopathy is not very clear, but there are still some susceptibility factors such as patients should prevent infections, including respiratory and intestinal infections. In addition, patients with viral myocarditis can develop dilated cardiomyopathy if the disease is prolonged, so patients who have had myocarditis in the past should undergo regular review for early detection. Another point is that cardiomyopathy is related to genetic factors, so people with family history should have regular checkups. Secondary cardiomyopathy should be actively prevented and treated against the primary disease by controlling blood pressure, improving myocardial ischemia, replacing valves, and cautiously using drugs with cardiotoxicity to reduce the load on the heart and prevent the occurrence of cardiomyopathy. Cancer patients taking anti-tumor drugs or some psychiatric patients with some antidepressant drugs, long-term effect on the heart will have toxic side effects on the myocardium. So patients taking these drugs for a long time, once the corresponding symptoms should be regularly to the hospital for examination. 10, cardiomyopathy patients how to prevent sudden death? Although there are many kinds of treatments such as drugs, interventional therapy, surgery, etc., cardiomyopathy is still a disease with high mortality rate, so it is important to diagnose and control the development of the disease at an early stage. Patients, especially teenagers, should see a doctor if they experience a bout of panic, an unusually fast heartbeat and fainting; family members with a family history of sudden death in the young should be routinely examined. If there is a case of sudden death as a child in this family, then everyone related by blood should have a checkup including electrocardiogram, echocardiogram, etc., and do a nuclear magnetic examination if necessary. 11.How to eat reasonably for cardiomyopathy patients? Cardiomyopathy patients should pay attention to their diet, eat a light diet, forbid eating greasy food. And try to eat less and more meals, because full meals are one of the main triggers that induce the heart burden to increase. In addition, cardiomyopathy patients, especially in heart failure, must strictly control the intake of salt, if too much salt intake will aggravate the symptoms of edema. 12, cardiomyopathy patients how to reasonable physical exercise? Have myocarditis or congenital heart disease of young people and have high risk factors of the elderly friends, should avoid too strenuous exercise, because in addition to heart disease caused by sudden death, exercise is also an important cause of sudden death. Some experts have counted nearly 400 cases of sudden death in sports abroad, about 90% of the cases of sudden death in sports are related to heart diseases. In terms of physical exercise: the progress of the disease, to lie down to rest, avoid exertion; after the stabilization of the disease, should choose to aerobic exercise, moderate and moderate.