In most cases, treatment for dilated cardiomyopathy is done to relieve symptoms, improve heart function, and help you live longer. The majority of people will need to take a number of medications along with making healthy lifestyle changes. Surgical procedures may also be considered, especially when medications do not improve your condition.

In some cases the underlying cause of the condition can be successfully addressed, such as when dilated cardiomyopathy is caused by excessive alcohol consumption. Limiting how much you drink may help prevent the disease from progressing.

However, in viral myocarditis (inflammation of the heart muscle caused by a virus), there are no medications to attack the viruses that cause dilated cardiomyopathy.

Medications

Medications used to treat heart failure caused by dilated cardiomyopathy include:

• Angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and vasodilators, which widen blood vessels to improve blood flow and reduce the heart's workload. ACE inhibitors are considered the basis of therapy for dilated cardiomyopathy. They specifically have been shown to improve symptoms and prolong life in people who have heart failure.¹ ARBs may be used when a person cannot tolerate ACE inhibitors or the medication is not controlling symptoms. Other vasodilators may be used when a person cannot tolerate ACE inhibitors or ARBS, or the medications are not controlling symptoms.
• Beta-blockers, which slow the heart rate and reduce blood pressure. The heart can pump more efficiently when it has more time to relax. Carvedilol and metoprolol are beta-blockers that are currently approved for the treatment of heart failure. Studies show that adding beta-blockers to standard treatment with ACE inhibitors may reduce the rate of hospitalization or death in people with moderate or severe heart failure.¹
• Diuretics, to help remove excess fluid from the body. Spironolactone is a diuretic that prevents potassium loss and has been shown to prolong life in people with severe forms of heart failure.
• Inotropics, such as digoxin or digitoxin. These can help increase the strength of the heart muscle contraction, improve blood flow, and reduce symptoms of heart failure.
• Anticoagulants, such as warfarin (for example, Coumadin) and heparin, to prevent blood clots that can develop when blood is not being pumped efficiently through the heart and out to the rest of the body. Blood clots may lead to strokes or heart attack. People with both dilated cardiomyopathy and atrial fibrillation are at higher risk for developing blood clots.
• Antiarrhythmics, such as amiodarone, which control the heart rate when abnormal, rapid heartbeats (arrhythmias) are present.

For more information on these medications, see the topic Heart Failure.

Surgery

A pacemaker may be surgically placed in the upper chest to control potentially life-threatening abnormal heart rhythms (arrhythmias). Biventricular pacemakers are used in people who have heart failure and problems with the heart's electrical system. A biventricular pacemaker helps the heart beat regularly by making the lower chambers (ventricles) contract together.