Treatment

If you have dilated cardiomyopathy, your doctor might recommend treatment for the underlying cause, if known. Treatment may also be suggested in order to improve blood flow and prevent further damage to your heart.

Medications

Doctors usually treat dilated cardiomyopathy with a combination of medications. Depending on your symptoms, you might need two or more of these drugs.

Drugs that have proved useful in the treatment of heart failure and dilated cardiomyopathy include:

  • Angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors are a type of drug that widens or dilates blood vessels (vasodilator) to lower blood pressure, improve blood flow and decrease the heart's workload. ACE inhibitors may improve heart function.

    Side effects include low blood pressure, low white blood cell count, and kidney or liver problems.

  • Angiotensin II receptor blockers. These drugs have many of the beneficial effects of ACE inhibitors and may be an alternative for people who can't tolerate ACE inhibitors. Side effects include diarrhea, muscle cramps and dizziness.
  • Beta blockers. A beta blocker slows your heart rate, reduces blood pressure and may prevent some of the harmful effects of stress hormones, which are substances produced by your body that can worsen heart failure and trigger abnormal heart rhythms.

    Beta blockers may reduce signs and symptoms of heart failure and improve heart function. Side effects include dizziness and low blood pressure.

  • Diuretics. Often called water pills, diuretics remove excess fluid and salt from your body. The drugs also decrease fluid in your lungs, so you can breathe more easily.
  • Digoxin. This drug, also known as digitalis, strengthens your heart muscle contractions. It also tends to slow the heartbeat. Digoxin may reduce heart failure symptoms and improve your ability to be active.
  • Blood-thinning medications. Your doctor may prescribe drugs, including aspirin or warfarin, to help prevent blood clots. Side effects include excessive bruising or bleeding.

Devices

Implantable devices used to treat dilated cardiomyopathy include:

  • Biventricular pacemakers, which use electrical impulses to coordinate the actions of the left and right ventricles.
  • Implantable cardioverter-defibrillators (ICDs), which monitor heart rhythm and deliver electrical shocks when needed to control abnormal, rapid heartbeats, including those that cause the heart to stop. They can also function as pacemakers.
  • Left ventricular assist devices (LVADs), which are mechanical devices implanted into the abdomen or chest and attached to a weakened heart to help it pump. They usually are considered after less invasive approaches are unsuccessful.

Heart transplant

You may be a candidate for a heart transplant if medications and other treatments are no longer effective.

July 26, 2017
References
  1. Tintinalli JE, et al. Cardiomyopathies and pericardial disease. In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2016. http://accessmedicine.mhmedical.com. Accessed May 22, 2017.
  2. Fuster V, et al, eds. Dilated cardiomyopathy. In: Hurst's The Heart. 14th ed. New York, N.Y.: McGraw-Hill Education; 2017. http://accessmedicine.mhmedical.com. Accessed May 22, 2017.
  3. Cardiomyopathy. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/book/export/html/4916. Accessed May 24, 2017.
  4. Dilated cardiomyopathy. American Stroke Association. http://www.strokeassociation.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_312224.pdf. Accessed May 24, 2017.

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