LV dilatation + systolic dysfunction not explained by loading or ischaemia.
Causes
- • Idiopathic/genetic (30%)
- • Viral (post-myocarditis)
- • Alcohol, cocaine
- • Chemotherapy (anthracyclines, trastuzumab)
- • Peripartum
- • Tachycardia-induced
Investigations
- • Echo, ECG, BNP
- • Cardiac MRI (fibrosis, aetiology)
- • Coronary angio (exclude ischaemia)
- • Genetic testing + family screening
Management
- • Standard HFrEF therapy (4 pillars)
- • Alcohol cessation, chemotherapy adjustment
- • ICD if EF ≤35% + NYHA II-III
- • CRT if QRS ≥130 ms LBBB
Complications
- • HF, arrhythmia, thromboembolism
Educational — verify locally.
