Treatment

If you have dilated cardiomyopathy, your doctor might recommend treatment for the underlying cause, if known. Treatment may help relieve symptoms, 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 drugs.

Drugs that are used to treat heart failure and dilated cardiomyopathy include:

• Angiotensin-converting enzyme (ACE) inhibitors. This type of medicine widens 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 a dry cough, low blood pressure, low white blood cell count, and kidney or liver problems. In rare cases, ACE inhibitors may cause certain areas of the tissues to swell (angioedema). If swelling occurs in the throat, it can be life-threatening.

• Angiotensin II receptor blockers (ARBs). These drugs may be an alternative for people who can't tolerate ACE inhibitors. Side effects include diarrhea, muscle cramps and dizziness.
• Sacubitril/valsartan (Entresto). This drug combines an ARB with another type of medicine to help your heart better pump blood to the rest of the body. It's approved for people with chronic heart failure who have heart weakness and enlargement.
• Beta blockers. This medication slows your heart rate and reduces blood pressure. It may prevent some of the harmful effects of stress hormones, which are substances made by your body that can worsen heart failure and trigger abnormal heart rhythms. Side effects of beta blockers 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 (Lanoxin). This drug can strengthen your heart muscle contractions. It also tends to slow the heartbeat. Digoxin may reduce heart failure symptoms and improve your ability to be active.
• Ivabradine (Corlanor). This drug helps restore the heart's normal rhythm by slowing and regulating the heart rate.
• Blood-thinning medications (anticoagulants). Your doctor may prescribe these drugs to help prevent blood clots. Side effects include excessive bruising or bleeding.

Therapies

Devices

Implantable devices used to treat dilated cardiomyopathy include:

• Biventricular pacemaker. This device sends out electrical signals to control contractions between the heart's left and right ventricles.
• Implantable cardioverter-defibrillators (ICD). An ICD monitors your heart rhythm and delivers electrical shocks when needed to control abnormal, rapid heartbeats, including those that cause the heart to stop. An ICD can also function as a pacemaker.
• Left ventricular assist devices (LVAD). This mechanical device is implanted into the abdomen or chest and attached to a weakened heart to help it pump. An LVAD may be used as a long- or short-term therapy for people waiting for a heart transplant. They usually are considered after less invasive approaches are unsuccessful.

Surgery or other procedures

Heart transplant

Your doctor may recommend a heart transplant if medications and other treatments for dilated cardiomyopathy no longer work for you.