The term cardiomyopathy generally denotes a progressive disease in clinical cardiology.There was a time diagnosis of dilated cardiomyopathy (DCM ) was synonymous with a delayed death sentence ! Of course , the situation has vastly improved over the years with the availability of new medical , interventional and surgical management. Still , there is no denying the fact , DCM continues to have a grave outcome especially when it occurs without any identifiable cause .
While we have variety of aggressive DCMs , we also have patients with relatively benign forms of dilated and dysfunctional hearts which recover totally .
This reversible forms of DCM is observed in the following situations.
Hypertensive dilated cardiomyopathy . The left ventricle in some of the patients with severe SHT respond to the stress (Increased after load) by dilatation rather than hypertrophy. This is especially common after an episode of LVF. If we do an acute echocardiogram the LV function is severely impaired and the LV may also be dilated. With good control of BP and fluid management the ventricle promptly return to it’s baseline dimension. The recovery is complete in many . (The mechansim of LV dysfunction acute severe Hypertension is referred to as Pre-load /After load mismatch) Link to concept of Pre load mismatch .
* Note in the past these entities were not called as cardiomyopathy .
Peri partum cardiomyopathy.
This is a serious disorder of cardiac muscles that occur during pregnancy few months before or few months after delivery . There is correlation between PIH and this entity. Prognosis varies between very bad to excellent. Very few cardiac entities have a natural history like this one disease of women.Most of the pregnant women regain their original cardiac status within year or so. It should be recalled there is high chances of recurrence in next pregnancy.
Alcoholic cardiomyopathy.
The toxic response to alcohol or the additive cobalt can result in DCM .There is overlap between holiday heart syndrome and alcoholic DCM , where atrial fibrillation is the major problem. Wet Beri beri is the advamced form of clinical DCM that respond to vitamin B therapy.
Tachycardic cardiomyopathy.
This is also a common entity that occur during persistent sinus tachycardia or AF , thyrotoxicosis.Beta blockers are of great use here. Recovery is usual if the primary cause is correctable.
Toxic and drug related reversible LV dysfunction
Adriamycin cardiomyopathy
Tako -Subot Cardiomyopathy canbe termed as classic form of reversible stress cardiomyopathy
Miscellaneous conditions
Diabetes and chronic kidney disorders are known to have a reversible form of cardiomyopathy
Some rare toxins , scorpion envenomation , selenium deficiency can result in reversible DCM
**Ischemic DCM are partially correctable in many , still we don’t include it as cause for reversible DCM
*** Many episodes of acute myocarditis can have transient or short term LV dialtation and dysfunction.they are classified as myocarditis .But there is little difference (Except acadmeic . . .) between chronic myocarditis with LV dysfucntion and cardiomyopathy.
Dr.S.Venkatesan MD 
I was diagnosed with left ventricular dilated cardiomyopathy in April 2009. I was in Stage 4 heart failure with an ejection fraction of 15%. There was no known cause however I did have chemotherapy back in 1989-1990 (adriamycin and cisplatin). When diagnosed with DCM I could not sleep, lying down or otherwise. I could not walk a few steps without wheezing and gasping for air. My body from the waist down was remakably swollen to the point where the skin on my feet was actually tearing.
At 3 months after diagnosis my echo showed an improvement in size and shape of my heart and an ejection fraction of 37. Both my warfarin and furosemide were stopped. I take the lowest doses of enalpril and carvedilol. At 6 months my echo showed that my heart completely reverse remodelled and an ejection fraction of 56. I have been completely symptom free since a few months after diagnosis.
I had not seen my cardiologist since my 6 month check up until a few weeks ago. He is debating taking me off all medications and calling me disease free. I had an echo but did not get results yet. I did notice on the monitor that my ef was 56.4. My blood pressure is always perfect and my resting heart rate is 60. I see my cardiologist again on October 13th and am debating what I will do if he does suggest taking me off all meds. I have done my research and found that if my heart dilates again it is very unlikely that it will recover again. I have tried to find something online that suggests that it is possible to be cured of this disease but cannot find anything that supports this.
I am looking for someone to point me to some documentation that will help me make my decision.
Lisa Bonaparte
lisambonaparte@hotmail.com
While living in Prague, I suffered a sudden cardiac arrest event in 2012. About 15 days before that, I had been bitten by a tick while camping outside of the city. The doctors suspected an infection, but they didn’t ask me about tick bites and they didn’t check me for Lyme Disease. My doctors in California didn’t either. Slowly, over years my heart began to enlarge. I was diagnosed with dilated cardiomyopathy with severe LV involvement. My Ejection Fraction dropped from 40 in 2012 to Just 18 in 2016. I was placed on the heart transplant list. While waiting, I discussed with my doctors the tick bite before my heart event in 2012. They checked me for Lyme and I was positive. They treated me with IV Rocephin for three months. After 6 months, my EF was back up to 32. Six months after that, my EF was 56. I no longer take any heart medications and I remain disease free. I went to see an ILLADS doctor, and he has been excellent about treating my Lyme Disease. It seems to me that Lyme Disease should definitely also be counted as a reversible form of dilated cardiomyopathy.