Dilated cardiomyopathy causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sachin Shah, M.D. Ogheneochuko Ajari, MB.BS, MS [2]


There are many causes of dilated cardiomyopathy. The most common cause is idiopathic in 50% of cases. The next most common cause is myocarditis which is responsible for 10% of cases. The high percentage of idiopathic dilated cardiomyopathy may be related to the difficulty in diagnosing viral myocarditis. Other common causes include substance abuse, connective tissue disease, pregnancy, medications, nutritional deficiencies, infiltrative diseases and toxins. There are varying degrees of severity of the disease. Some forms are reversible and some are irreversible; some patients may be completely asymptomatic and some may require cardiac transplantation.


There are several recorded causes for dilated cardiomyopathy. [1][2][3][4][5]

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Alstrom syndrome, amyloidosis, Carvajal-Huerta syndrome, coronary artery disease, endocardial fibroelastosis, eosinophilic cardiomyopathy, hemochromatosis, hypersensitivity myocarditis, hypertension, hypertensive heart disease, ischemic cardiomyopathy, ischemic heart disease, Kawasaki disease, myocarditis, myxoma, peripartum cardiomyopathy, rheumatic fever, Salih myopathy, tachycardia, x-linked dilated cardiomyopathy
Chemical/Poisoning Beryllium, carbon monoxide poisoning, cobalt, heavy metals, lead, mercury, toxins
Dental No underlying causes
Dermatologic Carvajal-Huerta syndrome, dermatomyositis, familial cutaneous collagenoma, scleroderma
Drug Side Effect Adriamycin, amphetamines, anthracyclines, antiretroviral drugs, bleomycin, certolizumab pegol,chemotherapeutic agents, chloroquine, clozapine, cyclophosphamide , didanosine, disopyramide, doxorubicin, epirubicin, idarubicin, imatinib mesylate, lithium , methysergide, mitoxantrone, paracetamol, peplomycin, phenothiazines, tacrolimus, trastuzumab, zalcitabine, zidovudine
Ear Nose Throat No underlying causes
Endocrine Acromegaly, amyloidosis, Cushing's syndrome, diabetes mellitus, hemochromatosis, hyperparathyroidism, hypoparathyroidism, hypothyroidism, myxedema, pheochromocytoma, pituitary tumor
Environmental Heat stroke
Gastroenterologic Hemochromatosis, sarcoidosis, Whipple's disease
Genetic Alstrom syndrome, Barth syndrome, Becker muscular dystrophy, desmin-related myopathy, Duchenne's muscular dystrophy, Emery-Dreifuss muscular dystrophy, X-linked, Erb dystrophy, Fabry's disease, familial cutaneous collagenoma, Friedreich's ataxia, hemochromatosis, Laing distal myopathy, limb girdle muscular dystrophy, McLeod neuroacanthocytosis syndrome, McLeod phenotype, Naxos disease, Salih myopathy
Hematologic Hemochromatosis, McLeod neuroacanthocytosis syndrome, McLeod phenotype
Iatrogenic Radiation
Infectious Disease Adenovirus, brucellosis, Chagas disease, Coxsackie virus, cryptococcosis, cytomegalovirus, diphtheria, echovirus, Epstein-Barr virus, hepatitis, histoplasmosis, HIV infection, influenza virus, leptospirosis, Loa loa, Lyme disease, myocarditis, parvovirus, psittacosis, rheumatic fever, schistosomiasis, syphillis, toxoplasmosis, trichinosis, trypanosomiasis, typhoid fever, varicella
Musculoskeletal/Orthopedic Becker muscular dystrophy, desmin-related myopathy, Duchenne's muscular dystrophy, Emery-Dreifuss muscular dystrophy, X-linked, Erb dystrophy, hemochromatosis, Laing distal myopathy, limb girdle muscular dystrophy, myotonic dystrophy, rheumatoid arthritis, Salih myopathy
Neurologic Friedreich's ataxia, giant cell arteritis, Refsum's disease, sleep apnea
Nutritional/Metabolic Beriberi, carnitine, Fabry's disease, glycogenosis type 2b, hypocalcemia, hypophosphatemia, isobutyryl-CoA dehydrogenase deficiency, niacin, nutritional deficiencies, pellagra, Refsum's disease, selenium deficiency, thiamine, triosephosphate isomerase deficiency
Obstetric/Gynecologic Childbirth, pregnancy
Oncologic Myxoma, pheochromocytoma, pituitary tumor
Ophthalmologic Giant cell arteritis
Overdose/Toxicity Alcohol abuse, cocaine, ethanol, substance abuse
Psychiatric No underlying causes
Pulmonary Sarcoidosis
Renal/Electrolyte Uremia
Rheumatology/Immunology/Allergy Amyloidosis, connective tissue disease, dermatomyositis, giant cell arteritis, rheumatic fever, rheumatoid arthritis, sarcoidosis, scleroderma, serum sickness, systemic lupus erythematosis, transplant rejection
Sexual No underlying causes
Trauma Electric shock
Urologic No underlying causes
Miscellaneous Heat stroke, hypothermia , idiopathic

Causes in Alphabetical Order


  1. Felker GM, Thompson RE, et al. Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy. N Engl J Med 2000 Apr 13;342(14):1077-84.
  2. Japp AG, Gulati A, Cook SA, Cowie MR, Prasad SK (2016) The Diagnosis and Evaluation of Dilated Cardiomyopathy. J Am Coll Cardiol 67 (25):2996-3010. DOI:10.1016/j.jacc.2016.03.590 PMID: 27339497
  3. Baris L, Cornette J, Johnson MR, Sliwa K, Roos-Hesselink JW (2019). "Peripartum cardiomyopathy: disease or syndrome?". Heart. 105 (5): 357–362. doi:10.1136/heartjnl-2018-314252. PMC 6613742 Check |pmc= value (help). PMID 31693481.
  4. Weintraub RG, Semsarian C, Macdonald P (2017). "Dilated cardiomyopathy". Lancet. 390 (10092): 400–414. doi:10.1016/S0140-6736(16)31713-5. PMID 28190577.
  5. Favalli V, Serio A, Grasso M, Arbustini E (2016). "Genetic causes of dilated cardiomyopathy". Heart. 102 (24): 2004–2014. doi:10.1136/heartjnl-2015-308190. PMID 27634407.

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