cardiovascular disorders
Dilated Cardiomyopathy
Introduction
Dilated cardiomyopathy is myocardial dysfunction causing heart failure in which ventricular dilation and systolic dysfunction predominate. Symptoms include dyspnea, fatigue, and peripheral edema. Diagnosis is clinical and by elevated natriuretic peptides, chest x-ray, echocardiography, and MRI. Treatment is directed at the cause. Standard heart failure treatment measures are used (eg, angiotensin-converting enzyme inhibitors, beta-blockers,aldosteronereceptor blockers,angiotensin IIreceptor blockers, ARNI [angiotensin IIreceptor blocker and neprilysin inhibitor], sodium glucose cotransporter 2 protein [SGLT2] inhibitors,hydralazine/nitrates, diuretics,digoxin). If heart failure is progressive and severe, cardiac resynchronization therapy, implantable cardioverter-defibrillator, repair of moderate to severe valvular regurgitation, left ventricular assist device, or heart transplantation may be needed. A cardiomyopathy is a primary disorder of the heart muscle (see also Overview of Cardiomyopathies ). Dilated cardiomyopathy can develop at any age but is more common in adults younger than about 50 years of age. About 10% of people who develop dilated cardiomyopathy are older than 65. In the United States, the disorder occurs in 3 times as many males than in females and in twice as many people of African ancestry compared with White people ( 