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Management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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:

  1. British Heart Foundation (1999). Factfile 1/99, Dilated Cardiomyopathy.
  2. Pulse (May 28th 2005): 54-61.

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