Dilated cardiomyopathy

Dilated cardiomyopathy (DCM), also known as congestive cardiomyopathy, is a heart muscle disease characterized by enlargement (dilation) and impaired contraction of the left ventricle or both ventricles. The heart chambers stretch and thin, reducing the heart's ability to pump blood efficiently throughout the body. This progressive condition primarily affects the cardiovascular system and can lead to heart failure, arrhythmias (abnormal heart rhythms), thromboembolism (blood clots), and sudden cardiac death. DCM can be caused by genetic mutations (familial DCM, accounting for 20–50% of cases), or it may be acquired through viral infections, alcohol use, toxins, autoimmune conditions, or other systemic diseases. In many cases, no identifiable cause is found (idiopathic DCM). Key symptoms include shortness of breath (dyspnea), particularly during exertion or when lying flat, fatigue, exercise intolerance, peripheral edema (swelling of the legs and ankles), palpitations, and in advanced cases, signs of congestive heart failure such as fluid retention and reduced exercise capacity. Some patients may be asymptomatic in early stages, with the condition discovered incidentally through imaging studies. Arrhythmias, including atrial fibrillation and ventricular tachycardia, are common complications that can significantly impact prognosis. Treatment of dilated cardiomyopathy focuses on managing heart failure symptoms and preventing complications. Standard medical therapy includes ACE inhibitors or angiotensin receptor blockers, beta-blockers, mineralocorticoid receptor antagonists, and diuretics. Newer agents such as sacubitril/valsartan (ARNI) and SGLT2 inhibitors have also become part of guideline-directed medical therapy. Anticoagulation may be prescribed to reduce thromboembolic risk. Implantable cardioverter-defibrillators (ICDs) are recommended for patients at high risk of sudden cardiac death, and cardiac resynchronization therapy (CRT) may benefit those with conduction abnormalities. In end-stage disease, left ventricular assist devices (LVADs) or heart transplantation may be considered. Familial cases warrant genetic counseling and screening of first-degree relatives.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

Common questions about Dilated cardiomyopathy