Dilated cardiomyopathy in children

Dilated cardiomyopathy (DCM) is the most common paediatric heart muscle disease, and the most common indication for cardiac transplantation in this age group. In terms of aetiology, DCM is a heterogeneous condition, with infectious, inflammatory, metabolic and genetic causes, although the precise pathogenesis remains unknown in most patients. Because some of the causes of DCM are potentially reversible, an extensive panel of investigations should be performed at first presentation, which we describe here. Treatment usually begins with pharmacological therapy, including beta-blockers, ACE inhibitors, digoxin, and diuretics. Cardiac transplantation and the recently introduced mechanical ventricular assist devices are alternatives when medical management is not effective.