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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.

Whether a cause can be identified or not, treatment is focused on relieving the symptoms, as well as on relieving the extra load on the heart. Lifestyle changes, medicines, and/or surgery may be needed. A person with cardiomyopathy may suffer an embolus before any other symptom of cardiomyopathy appears. That’s why anti-clotting (anticoagulant) drug therapy may be needed. Arrhythmias may require antiarrhythmic drugs. More rarely, “heart block” may develop, requiring an artificial

pacemaker. Therapy for dilated cardiomyopathy is sometimes disappointing, however. If the person is young and otherwise healthy, and if the disease gets worse and worse, a heart transplant may be considered.

When cardiomyopathy results in a significantly enlarged heart, the mitral and tricuspid valves may not be able to close properly, resulting in murmurs. Blood pressure may increase because of increased sympathetic nerve activity. These nerves can also cause arteries to narrow. This mimics hypertensive heart disease (high blood pressure). That’s why some people have high blood pressure readings. Because the blood pressure determines the heart’s workload and oxygen needs, one treatment approach is to use vasodilators (drugs that “relax” the arteries). They lower blood pressure
and thus the left ventricle’s workload.

Some people may need to lose weight and stop smoking. You should also try to get enough sleep, limit how much salt you eat, and start a moderate exercise program that has been approved by your doctor. Improving your overall fitness can help ease the demands on your heart and help your medicines work better.

Years ago the statistic was that the majority of patients, particularly those over 55 years of age, died within 3 years of the onset of symptoms (stage 5 of CHF) – and such figures can still be found in many textbooks.[citation needed] The situation has improved dramatically in recent years with drug therapy that can slow down progression and in some cases even improve the heart condition. Death is due to either congestive heart failure or ventricular tachy- or bradyarrhythmias.

Patients are given the standard therapy for heart failure, typically including salt restriction, angiotensin-converting enzyme (ACE) inhibitors, diuretics, and digitalis. Anticoagulants may also be used. Alcohol should be avoided. Artificial pacemakers may be used in patients with intraventricular conduction delay, and implantable cardioverter-defibrillators in those at risk of arrhythmia. These forms of treatment have been shown to improve symptoms and reduce hospitalization.

In patients with advanced disease who are refractory to medical therapy, cardiac transplantation may be considered.

The progression of heart failure is associated with left ventricular remodeling, which manifests as gradual increases in left ventricular end-diastolic and end-systolic volumes, wall thinning, and a change in chamber geometry to a more spherical, less elongated shape. This process is usually associated with a continuous decline in ejection fraction. The concept of cardiac remodeling was initially developed to describe changes which occur in the days and months following myocardial infarction. It has been extended to cardiomyopathies of non-ischemic origin, such as idiopathic dilated cardiomyopathy or chronic myocarditis, suggesting common mechanisms for the progression of cardiac dysfunction. Literally, reverse remodeling is the process of reversing the remodeling, or in other words, it is a process of a temporary or a permanent correction of the heart. A 2004 article gives a description of the current therapies that support reverse remodeling and suggests a new approach to the prognosis of cardiomyopathies.

Alternative treatment:Alternative treatments are promoted by some, including food supplements Coenzyme Q10, L-Carnitine, Taurine and D-Ribose, and there is some evidence for the benefits of Coenzyme Q10 in treating heart failure. The majority of doctors doubt the effectiveness of these alternative treatments, but a few complement conventional treatment by suggesting Coenzyme Q10.

The person may need to stay in the hospital until acute symptoms start to go away. Treatment is focused on relief of symptoms. Drugs and treatments that may be used include:

1.Vasodilators (drugs that dilate blood vessels)
2.Other medications to reduce symptoms
3.Nutritional supplements
4.Diuretics (water pills)
5.Digitalis
6.ACE-inhibitors

The underlying cause should be treated. Some people may require a biventricular pacemaker. An implantable defibrillator may also be needed to correct or prevent any severe arrhythmias (abnormal heart rhythms). A biventricular pacemaker that also functions as a defibrillator is available.

A low-salt diet may be prescribed for adults, and fluid may be restricted in some cases. The person can usually continue their regular activities, if they are able.

The person may be asked to monitor his or her body weight daily. Weight gain of 3 pounds or more over 1 or 2 days may indicate fluid accumulation (in adults).Smoking and drinking alcohol may worsen the symptoms.If the heart function remains poor, a heart transplant may be considered.