Chapter-112 Management of Dilated Cardiomyopathy

BOOK TITLE: CSI: Cardiology Update 2014

1. Bahl Ajay
2. Talwar KK
Publishing Year
Author Affiliations
1. IMA College, Postgraduate Institute of Medical Education and Research, Chandigarh, India, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, Advance Cardiac Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India, PGI, Chandigarh, India, PGIMER, Chandigarh, India, Postgraduate Institute of Medical, Education and Research (PGIMER), Chandigarh, India
2. Health and Medical Education, Government of Punjab; Punjab Governance Reforms Commission, Max Super Speciality Hospital, New Delhi, India, Postgraduate Institute of Medical Education, and Research, Chandigarh, India, President, Medical Council of India, Max Super Specialty Hospital, New Delhi, India, Max Healthcare, Max Super Speciality Hospital, Saket, New Delhi, India, Max Superspecialty Hospital, New Delhi, India
Chapter keywords
Familial DCM, Titin truncating mutations, Endomyocardial biopsy, aldosterone antagonists, angiotensin receptor blockers


Dilated cardiomyopathy (DCM) is characterized by dilation and impaired contraction of left or both ventricles associated with systolic dysfunction. It may lead to decline in left ventricular contractile function and progressive heart failure, arrhythmias, conduction system abnormalities, thromboembolism and sudden or heart failure related death. Dilated cardiomyopathy may be idiopathic or caused by a number of secondary causes such as myocarditis, alcohol, endocrine conditions, chemotherapeutic agents, etc. DCM can be diagnosed by echocardiographic findings of left ventricular or biventricular dilation and systolic dysfunction. Electrocardiogram (ECG) can distinguish DCM from coronary artery disease. Prolongation of QRS may occur and increasing QRS duration is associated with worse outcomes. Magnetic resonance imaging and endomyocardial biopsy may be useful. Condition can be treated by drugs that improve survival include angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARBs), beta-blockers and aldosterone antagonists. Diuretics and digoxin produce symptomatic relief.

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