George Michael's cause of death: What is dilated cardiomyopathy?
George Michael died of heart disease and a build-up of fat in his liver, a coroner has said.
The singer, who was found dead on Christmas Day, was suffering from dilated cardiomyopathy with myocarditis and a fatty liver, which can be linked to drug and alcohol abuse.
The 53-year-old, whose hits included Last Christmas and Freedom, suffered health scares and fought drug addiction for years.
Oxfordshire’s senior coroner, Darren Salter, said inquiries into Michael’s death were now over and the final post-mortem examination report has been received.
There will not be an inquest because the Wham! star died of natural causes.
He added: “No further updates will be provided and the family requests the media and public respect their privacy.”
Michael’s boyfriend, Fadi Fawaz, tweeted a black and white photograph of him being embraced by Michael with the caption: “The Truth is out…”
Dilated cardiomyopathy is a disease of the heart muscle. The left ventricle of the heart becomes stretched, thin and weaker, which affects how blood is able to pump around the body.
In some cases, it is an inherited condition – people with this form have a 50% chance of passing it on to their children.
Otherwise, it is caused by things such as viral infections, uncontrolled high blood pressure and problems with the heart valves.
A lack of vitamins and minerals in the diet, heavy drinking and recreational drug use can also lead to the condition.
As the heart is not pumping effectively, fluid can build up in the lungs, ankles, abdomen and other organs – causing heart failure.
Most symptoms come on slowly but include shortness of breath, swelling of the ankles and stomach and excessive tiredness.
Myocarditis is inflammation in or around the heart and is usually caused by a viral, bacterial or fungal infection.
Symptoms include pain or tightness in the chest which can spread to other parts of the body. Other symptoms are shortness of breath and tiredness.
Myocarditis is potentially fatal, although it sometimes exhibits no symptoms at all.
It is notoriously hard to detect and can lead to heart failure in severe cases.
People can sometimes have a high temperature, suffer headaches and have aching muscles and joints.
Non-alcoholic fatty liver disease is caused by a build-up of fat in the liver and is usually seen in people who are overweight or obese.
About one in three people in the UK are thought to be in the early stages of non-alcoholic fatty liver disease.
While it usually causes no harm, it can lead to serious liver damage and increases the risk of diabetes, heart attacks and strokes.
A different type of fatty liver disease is caused by excessive drinking and is known as alcoholic fatty liver disease. It can be reversible if people stop drinking.
According to the British Heart Foundation, there is no cure for dilated cardiomyopathy.
Some people develop other conditions as a result of it, including abnormal heart rhythms, blood clots or chest pain.
Andrew Langford, chief executive of the British Liver Trust, said: “We are saddened to hear that a fatty liver may have contributed to George Michael’s untimely death.
“Many people in the UK are unaware of this type of liver disease.
“More than one in five of us are at risk and, unfortunately, many people don’t realise that being overweight is a major risk factor.
“Non-alcohol related fatty liver disease often has no symptoms in the early stages so it’s important that all of us are aware of the importance of eating a nutritious balanced diet and maintaining a healthy weight.”