5th July 2026

Diagnosis

Signs and symptoms

Patients with DCM may present with symptoms of:

• cardiac failure: shortness of breath on exertion, orthopnoea, fatigue, paroxysmal nocturnal dyspnoea, abdominal discomfort, or leg swelling

Clinical signs that may be elicited on examination include: 

• bilateral basal crackles on lung auscultation
• hepatomegaly
• jugular venous distension
• peripheral oedema
• S3 gallop during rapid ventricular phase of diastole, indicating ventricular dilatation

Investigations

All patients with suspected DCM require a comprehensive diagnostic work-up to identify the aetiology and provide morphological and prognostic information. They include a detailed series of serological and genetic testing in addition to imaging modalities as described in Table 2. 

Table 2: List of investigations involved in the diagnostic workup of DCM.