[Dilated cardiomyopathy].

Dilated cardiomyopathy (DCM) has a familial accumulation in 20-50% of cases and, therefore, frequently has a genetic cause. Currently, numerous mutations are known in more than 40 genes, which account for around 20% of familial cases. The structured evaluation of family history with recording of a family tree is an obligatory part of the initial diagnosis of DCM. By evaluation of family members other persons at risk can be identified. With the exception of the lamin A/C gene (LMNA), genetic testing does not allow risk stratification. DCM caused by LMNA mutations is associated with a high risk of sudden cardiac death. In cases of familial conduction disease, sudden cardiac death and a concomitant muscle disease LMNA mutation should be excluded. Implantation of an ICD is indicated if the LVEF is chronically less than 35% independent from etiology. This applies with some restrictions for asymptomatic patients in NYHA class I. Patients should receive optimal drug therapy for 3-12 months before ICD implantation.