The morphology study attack in such cases reveal many small rubchikov (not resulting from coronary atherosclerosis). Additional research tools were not binding on the diagnosis, but their results provide a detailed hemodynamics disorders and the nature of morphological changes occurred. The study of central hemodynamics identifies low hotel and knock the (hotel and knock indices), the rise in pressure in the pulmonary artery. Angiocardiograficesc and found the same changes as the ehocardiogramme. Myocardial biopsy neinformativa to determine the etiology of cardiomyopathy. In some cases, bioptate detectable viral antigen, or an increase of LDG and the deterioration energoproduktion muthondriami. Myocardial biopsy considerably helps differential diagnosis of dilatation cardiomyopathy and heart disease, the processes with the view of the increase in the : 1. with heavy diffuse miocarditah found cell infiltration stroma with distroficescimi and nekroticakimi changes cardiomyocytes; 2. in the primary amiloidoze, with the ongoing heart failure (so-called option cardiopaticeski amiloidoza Primary), there is a significant delay in amiloida intersticialna myocardial tissue, combined with the atrophy of muscle fibers; 3. in gemohromatose (disease caused by violation of iron) miocarde find sediments iron pigment, have varying degrees of liver and muscle atrophy fibres growing connective tissue. Diagnostics. Recognition dilatation cardiomyopathy is considerable difficulties, as a significant increase in the hearts of the absence or presence of heart failure meets with greater or lesser frequency in other heart diseases. Among these diseases, diffuse myocarditis heavy currents disease (postinfarknetary cardiosclerosis development anevrizma heart), acquired heart disease in the total congestive heart failure and hypertension is coming stages, the disease accumulation (hemochromatosis, primary amiloidoz Most heart failure). Treatment. The treatment dilatation cardiomyopathy -- the developing congestive heart failure that is on the general principles (especially limitation of physical activity and consumption of table salt to 1 g / day). The most effective use of mochegonnah drugs. The advantage is given to the so-called looped dioretikam - furosemidou and etakrinova acid (uregit). Dose preparation and the reception frequency varies depending on the stage of circulatory failure. The start treatment with low doses : furosemide 40 mg, uregit 25-50 mg morning prandial 1-3 times a week. DPPB inhibitors angiotenzinprevrashchau general enzyme : captopril (capoten) 25-100 mg / day, amlodipine (renitek, anap) 2.5 mg / day, ramipril 1,25-10 mg / sut. In appointing these drugs should take into account the value of AD, as they reduce the AD. To avoid hypotonia, treatment start with small doses and having in the absence of express gipotenzivnogo effect dose of the drug increases. Good health effects vazodilatatornyi have isosorbide dinitrate, cardicket, nitrosorbid has led to a decline in the flow of blood to the right heart.
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