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 medicines along with making healthy lifestyle changes. Surgical procedures may also be considered, especially when medicines do not improve your condition.

In some cases, the 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.

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

Medications

Medicines 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. ARBs may be used when a person cannot tolerate ACE inhibitors or the medicine is not controlling symptoms. Other vasodilators may be used when a person cannot tolerate ACE inhibitors or ARBS or the medicines 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. 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.
• 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.
• Digoxin, which 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 medicines, see the topic Heart Failure.

Surgery

A pacemaker for heart failure may be surgically placed in the upper chest. This pacemaker helps your heart pump blood. This pacemaker makes both lower chambers of the heart (ventricles) pump blood at the same time. Because both ventricles beat at the same time, this pacemaker is also called a biventricular pacemaker. It can help you feel better so you can be more active. It also can help keep you out of the hospital and help you live longer.¹ This pacemaker is also called cardiac resynchronization therapy. Sometimes this pacemaker is combined with an implantable cardioverter-defibrillator (ICD) to prevent sudden death from a life-threatening irregular heartbeat.