Dilated cardiomyopathy: Dilated cardiomyopathy: Clinical assessment and differential diagnosis

Abstract

Idiopathic dilated cardiomyopathy (DCM) is a primary heart-muscle disease characterized by dilation and systolic dysfunction of the left or both ventricles. It represents a frequent cause of heart failure (HF) and frequently deteriorates toward heart transplantation in relatively young patients. At least 30–50% of cases are familial, suggesting a relevant genetic involvement and highlighting the relevance on familial genetic screening. Postmyocarditis represents the other major cause of DCM. It affects mostly males during the fourth and fifth decades of life, with a low profile of comorbidity. Despite the impressive improvement in knowledge, pharmacological/nonpharmacological treatments and, subsequently, prognosis of this disease in the last 30 years, some critical issues remain challenging, such as prognostic stratification (particularly of arrhythmic events more so than HF-related events). DCM is an exclusion diagnosis when the other known causes of dilation and systolic dysfunction are excluded.