Dilated cardiomyopathy Treatment: medication, ventricular assist device, heart transplant – Doctor

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:

Devices (e.g. AICD)
Ventricular assist devices
Heart transplant

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.