Treatment of dilated cardiomyopathy depends on the causes. The goals of treatment are to reduce symptoms, improve blood flow and prevent further heart damage. Dilated cardiomyopathy treatment may include medications or surgery to implant a medical device that helps the heart beat or pump blood.
A combination of medications may be used to treat dilated cardiomyopathy and prevent any complications. Medications are used to:
- Control the heart's rhythm
- Help the heart pump better
- Lower blood pressure
- Prevent blood clots
- Reduce fluid from the body
Drugs that are used to treat heart failure and dilated cardiomyopathy include:
- Blood pressure medications. Different types of drugs may be used to lower blood pressure, improve blood flow and reduce the strain on the heart. Such medications include beta-blockers, angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).
- Sacubitril/valsartan (Entresto). This drug combines an ARB with another type of medicine to help the heart better pump blood to the rest of the body. It's used to treat those with chronic heart failure.
- Water pills (diuretics). A diuretic removes excess fluid and salt from the body. Too much fluid in the body strains the heart and can make it difficult to breathe.
- Digoxin (Lanoxin). This drug can strengthen heart muscle contractions. It also tends to slow the heartbeat. Digoxin may reduce heart failure symptoms and make it easier to be active.
- Ivabradine (Corlanor). Rarely, this drug may be used to manage heart failure caused by dilated cardiomyopathy.
- Blood-thinners (anticoagulants). These drugs help prevent blood clots.
Surgeries or other procedures
Surgery may be needed to implant a device to control the heart's rhythm or help the heart pump blood. Type of devices used to treat dilated cardiomyopathy include:
- Biventricular pacemaker. This device is for people who have heart failure and irregular heartbeats. A biventricular pacemaker stimulates both of the lower heart chambers (the right and left ventricles) to make the heart beat better.
- Implantable cardioverter-defibrillators (ICD). An ICD doesn't treat cardiomyopathy itself. It monitors the heart rhythm and delivers electrical shocks if an irregular heartbeat (arrhythmia) is detected. Cardiomyopathy can cause dangerous arrhythmias, including those that cause the heart to stop.
- Left ventricular assist devices (LVAD). This mechanical device helps a weakened heart pump better. A LVAD usually is considered after less invasive approaches are unsuccessful. It can be used as a long-term treatment or as a short-term treatment while waiting for a heart transplant.
If medications and other treatments for dilated cardiomyopathy no longer work, a heart transplant may be needed.