Treatment of end stage dilated cardiomyopathy

Abstract

Dilated cardiomyopathy continues to be a serious clinical problem with about 20 000 new patients affected in the United States each year. By definition, the cause of injury to the myocardium is unknown.1 Consequently, treatment is purely symptomatic because it cannot be specifically directed toward aetiology. In most cases, the major symptomatic presentations of dilated cardiomyopathy, arrhythmia, embolic phenomena, and congestive heart failure, are successfully managed, at least initially, by conventional treatment. However, if myocardial injury persists or is so severe that conventional treatment does not palliate the symptoms, cardiac transplantation remains the only viable alternative. In fact, 50% of those undergoing cardiac transplantation have dilated cardiomyopathy.2 In the present paper we describe the conventional management of dilated cardiomyopathy and discuss new approaches that may prolong survival and reduce morbidity.