How is DCM treated?

Treatment of cardiomyopathy is aimed at treating the cause of heart failure whenever possible. Once diagnosed, the primary goal is to improve cardiac function and reduce symptoms. Patients usually take several medications to treat DCM. Doctors also recommend lifestyle changes that decrease symptoms and hospitalizations, and improve quality of life.

Medications

Medications are used for two reasons:

  1. To improve cardiac function
  2. To treat symptoms and prevent complications

To manage heart failure, most people improve by taking a beta-blocker and ACE inhibitor even when not having symptoms. If symptoms occur and/or worsen,digoxin, diuretics, and aldosterone inhibitors may be added. Other medications will be added as needed. For example, if you have an arrhythmia, your doctor may give you a medication to control your heart rate or lessen the occurrence of arrhythmia. Or, blood thinners may be used to prevent blood clots from occurring. Your doctor will discuss what medications are best for you.

Lifestyle Changes
  • Diet. Once you develop symptoms such as shortness of breath or fatigue, you should restrict your intake of salt (sodium) to 2,000 to 3,000 mg per day. Follow this low-sodium diet even when your symptoms seem to have subsided. Most salt ingested comes from processed food. In addition to removing the salt shaker from the table and when cooking, read all food labels for sodium content and serving size so you can keep track of your sodium intake.
  • Learn more about nutrition guidelines for heart failure.
  • Exercise. Your doctor will tell you if you may exercise or not. Most people with cardiomyopathy are encouraged to do non-competitive aerobic exercise. Heavy weight lifting may not be recommended.
  • Learn more about heart failure lifestyle changes
Implantable Devices
  • Cardiac Resynchronization Therapy (CRT, such as biventricular pacing) : In some patients with advanced heart failure, biventricular pacing (a pacemaker that senses and initiates heartbeats in the right and left ventricle) improves survival, reduces symptoms and increases exercise capacity or tolerance. For people with heart block or some bradycardias (slow heart rates), this pacemaker will also serve to maintain an adequate heart rate.
  • Implantable Cardioverter Defibrillators (ICD) : ICDs are suggested for people at risk for life-threatening ventricular arrhythmias or sudden cardiac death. The ICD constantly monitors the heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy (shock) to the heart muscle to cause the heart to beat in a normal rhythm again.

Both devices may be combined in a single unit, usually labeled CRT-D.

Surgery

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