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Dilated Cardiomyopathy

Dilated Cardiomyopathy - What it is

Cardiomyopathy is a disease of the heart muscle. Due to various causes, the heart muscles become weak and/or stiff. This makes it harder for the heart to pump sufficient blood to supply the body’s needs. One of the most common types of cardiomyopathy is dilated cardiomyopathy. 

Dilated cardiomyopathy is a condition when the heart becomes enlarged and weak. In this condition, the heart muscle becomes stretched and thin. This causes the heart pump chambers to become enlarged or dilated. The stretched and enlarged heart becomes weak and is unable to pump blood normally. When the heart is unable to pump enough blood for the body’s needs, it could result in heart failure.

normal heart vs heart with dilated cardiomyopathy

Dilated Cardiomyopathy - Symptoms

Some patients may not experience any symptoms if the condition is mild. Most symptomatic patients complain of reduced effort tolerance. 

Other symptoms can include:
  • Breathlessness on lying down
  • Leg swelling
  • Fatigue

Dilated Cardiomyopathy - How to prevent?

​While for some individuals, dilated cardiomyopathy may be genetic and not always preventable, it is important to maintain a healthy lifestyle such as balanced diet, adequate exercise, and avoidance of smoking and excessive alcohol so as to reduce risk of heart failure and occurrence of the condition. Good control of medical conditions such as diabetes, blood pressure and thyroid disorders is also essential.

Dilated Cardiomyopathy - Causes and Risk Factors

Dilated cardiomyopathy may be inherited or be due to genetics, or it can be caused by other factors such as:

  • ​Viral infections causing heart muscle inflammation
  • Chemotherapy
  • Hyperthyroidism or thyroid disorders
  • Excessive alcohol intake
  • Diabetes
  • Obesity
  • Heart rhythm abnormalities
  • Certain drugs used to treat cancer and complications during pregnancy.
Dilated cardiomyopathy mostly occurs in adults aged 20 to 60 years old. Often, the exact cause of dilated cardiomyopathy may not be known even after investigations.

Dilated Cardiomyopathy - Diagnosis

​The condition is usually diagnosed by 

Dilated Cardiomyopathy - Treatments

It is important to start treatment as soon as possible, as dilated cardiomyopathy causes increased risks of death and hospitalisation. Studies have shown that on average, one out of five patients pass away from their weak heart function within a year of diagnosis1. Nearly half of all patients may get readmitted within a year.

Large majority of patients would only require medications to stabilise the condition and improve the symptoms. 

Other treatment options include:

There are proven medications (guideline-directed heart failure therapy) that can make the patients feel better and reduce the risk of hospitalisations and death from this condition. Use of guideline directed heart failure medications in combination can potentially reduce risk of death by approximately 70%. It is important to take the medications regularly and as prescribed. Treatment of underlying conditions such as heart rhythm abnormalities, thyroid disorders, cessation of alcohol and optimisation of diabetes, cholesterol and blood pressure control are also essential. Importantly, lifestyle measures such as reduced salt intake, management of fluid intake, smoking and alcohol cessation and prescribed physical activities also play an important role in the management of this condition.

If the heart pumping function remains severely depressed despite the above interventions, there is increased risk of abnormal heart rhythms occurring. The abnormal heart rhythm can lead to fainting episodes and/or sudden death. The cardiologist may discuss the options of implantation of specific devices such as implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy (CRT). These devices may reduce risk of sudden death due to dangerous heart rhythm.

In the event that patient’s condition is worsening despite medications and lifestyle measures, heart transplant or implantation of an artificial heart pump (left ventricular assist device) may be an option after careful consideration.


1 Conrad N, Judge A, Canoy D et al. Temporal Trends and Patterns in Mortality After Incident Heart Failure: A Longitudinal Analysis of 86000 Individuals. JAMA Cardiol 2019;4:1102-1111.

Dilated Cardiomyopathy - Preparing for surgery

Dilated Cardiomyopathy - Post-surgery care

Dilated Cardiomyopathy - Other Information

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