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There are many different causes of dilated cardiomyopathy, including severe and prolonged high blood pressure, iron overload, autoimmune diseases, drug abuse, chemotherapy, heart infections and end-stage kidney disease. In some cases the cause is unknown.

Although in many cases no cause (etiology) is apparent, dilated cardiomyopathy is probably the result of damage to the myocardium produced by a variety of toxic, metabolic, or infectious agents. It may be due to fibrous change of the myocardium from a previous myocardial infarction. Or, it may be the late sequel of acute viral myocarditis, possibly mediated through an immunologic mechanism. Autoimmune mechanisms are also suggested as a cause for dilated cardiomyopathy. A reversible form of dilated cardiomyopathy may be found with alcohol abuse, pregnancy (peripartum cardiomyopathy), thyroid disease, stimulant use, and chronic uncontrolled tachycardia. Many cases of dilated cardiomyopathy are described as idiopathic – meaning that the cause is unknown.

Recent studies have shown that those subjects who have an extremely high occurrence (several thousands a day) of premature ventricular contractions (extrasystole) can develop dilated cardiomyopathy. In these cases, if the extrasystole are reduced or removed (for example, via ablation therapy) the cardiomyopathy usually regresses.

Causes Of Dilated Cardiomyopathy:

1.Inherited dilated cardiomyopathy
2.Cobalt
3.Toxins
5.Viral myocarditis (type of Myocarditis)
6.Childbirth
7.Pregnancy
8.Excessive alcohol

The cause of Dilated Cardiomyopathy remains uncertain, but it is probable that there are many different factors that are important. These include viral infection. Usually viral infections are self-limiting illnesses as the body’s defence mechanism is able to control the virus, prevent it from spreading, and kill it. Enteroviruses are common causes of viral infections often presenting with flu like symptoms. One of the Enteroviruses, CoxsackieB, can affect the heart but does not usually cause permanent damage. In some instances however, the evidence suggests that the virus may either persist within the heart or trigger an auto immune process that continues to damage the heart muscle.

Cardiomyopathy literally means disease of the heart muscle. In DCM the heart muscle becomes thin and weakened. The heart muscle can be damaged in a number of ways including viral infections. Dietary deficiencies of taurine and carnitine have been reported as causes of DCM in some groups of dogs. Low levels of carnitine in the blood has been detected in some Boxers and Springer Spaniels with DCM, and some Cocker Spaniels with DCM may have low blood taurine levels. Since the disease is much more common in some breeds than others genetic factors are probably important. In most cases of DCM there is no apparent cause of the damage to the heart and this is termed idiopathic cardiomyopathy. Once the heart muscle is damaged it becomes weak and so does not contract well. Because heart contractions are weak the heart does not empty with each contraction and the blood supply to the body is reduced. Pulses are weak and the paws may feel cold. With time the heart muscle stretches and heart becomes a flabby sac. DCM eventually results in heart failure with fluid build-up in the lungs, the chest and belly.