Dilated cardiomyopathy: management and related morphological patterns
THE CONTEXT
Management of dilated cardiomyopathy focuses on heart failure control and reduction of sudden arrhythmic death risk.
Heart failure management and prognosis
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The main treatment goal is to control heart failure.
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Prognosis is variable: some patients remain well for many years, while cardiac transplantation may be indicated in others.
Prevention of sudden arrhythmic death
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Patients with dilated cardiomyopathy and moderate or severe heart failure are at risk of sudden arrhythmic death.
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Rigorous medical therapy with β-blockers and either ACE inhibitors or ARBs can reduce this risk.
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Selected patients may be considered for an implantable cardiac defibrillator, cardiac resynchronisation therapy, or both.
Cardiomyopathy patterns illustrated
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Hypertrophic cardiomyopathy may show asymmetric septal hypertrophy with systolic anterior motion of the mitral valve, causing mitral reflux and dynamic left ventricular outflow tract obstruction.
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Other illustrated hypertrophic patterns are concentric hypertrophy and apical hypertrophy.
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The figure also illustrates dilated, arrhythmogenic right ventricular, obliterative and restrictive cardiomyopathy.