Dilated Cardiomyopathy

Dilated cardiomyopathy is a major cause of heart failure with reduced ejection fraction characterized by ventricular dilation and impaired contractility.

In this episode, Chris and Mars review:

* The “big ventricle, weak squeeze” physiology of dilated cardiomyopathy

* Classic causes including alcohol, myocarditis, anthracyclines, genetic disease, peripartum cardiomyopathy, and tachycardia-mediated cardiomyopathy

* Key examination and echocardiographic findings

* How to distinguish dilated cardiomyopathy from ischemic, valvular, hypertrophic, and restrictive disease

* The role of cardiac M R I and genetic evaluation

* The four foundational medications for HFrEF

* Why reversible causes must be identified early

* Ventricular arrhythmias, sudden cardiac death, and left ventricular mural thrombus

* Why first-degree relatives may need cardiac and genetic screening

Episode pearl: A dilated, poorly contracting ventricle gives you the diagnosis pattern—but the next question should always be: why did it become dilated?

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