management
Last reviewed 11/2022
Patients should be advised to stop drinking because of:
- depressant effects of alcohol on heart muscle
- difficulty in diagnosing alcohol-induced cardiomyopathy
Treatment of cardiac failure:
- treatment with angiotensin converting enzyme (ACE) inhibitors and beta blockers in line with management of chronic cardiac failure
- diuretics for management of symptoms with congestion; digoxin may also be required
Anti-arrhythmic drugs:
- only necessary if symptomatic arrhythmias or ventricular ectopics are so frequent as to impair cardiac output
- amiodarone is the agent of choice
Anticoagulation:
- long-term anticoagulation is the rule rather than the exception for most patients
- is mandatory if there is co-existent atrial fibrillation
Other treatment options include cardiac transplantation and cardiomyoplasty.
Notes:
- if refractory symptoms and left bundle branch block then patient may benefit from a biventricular pacemaker (2)
- should be considered for an implantable cardioverter defibrillator
- patients with syncope (with or without documented ventricular arrhythmias) identifies a high risk cohort (2)
Reference:
- British Heart Foundation (1999). Factfile 1/99, Dilated Cardiomyopathy.
- Pulse (May 28th 2005): 54-61.