IntroductionDilated cardiomyopathy (DCM) is “a syndrome characterized by cardiac hypertrophy and impaired systolic function of one or both ventricles. »4(1175) Thanks to medical technology and proper medical regimen, people with this syndrome today are living longer and undergoing surgeries that may not be heart related. Therefore, anesthesiologists may encounter an increasing number of patients with DCM compared to the past. As anesthesiologists, it is important to understand the pathophysiology of DCM and its anesthetic implications. This topic will focus on the anatomy and physiology of DCM, its anesthetic effects, and a review of the current literature. Anatomy and Physiology Patients with dilated cardiomyopathy will often have normal thickness of the ventricles with enlargement on the right, left, or both. ventricular cavities. In the early stages of this disease, there is an initial increase in stroke volume due to increased force of contraction due to stretching of the myocardium, described by the Frank-Starling mechanism. However, as the disease progresses, the heart loses this compensatory mechanism leading to a decrease in the force of contraction of the heart, and therefore a decrease in left ventricular ejection fraction. There are two types of DCM, primary and secondary. Primary dilated cardiomyopathies are generally idiopathic in nature, however, “approximately 30% of cases” have a “familial mode of transmission”.3(138). Secondary dilated cardiomyopathies, on the other hand, are associated with "alcohol abuse, cocaine abuse, the peripartum state, pheochromocytoma, infectious diseases (human immunodeficiency virus infection), uncontrolled tachycardia, musculature of Duchenne... middle of paper ...... increased work of the heart. Conclusion Anesthetic management of patients with dilated cardiomyopathy is challenging. It is imperative that there is a complete preoperative assessment to tailor the anesthesia plan specifically to the patient. Ensure that the patient has an optimized cardiac status and does not have any symptoms of heart failure before elective surgical procedures, as this increases morbidity and mortality. The anesthetist must be very vigilant throughout the perioperative period and rapid administration of inotropes or antiarrhythmic drugs may be necessary. Patients with dilated cardiomyopathy present a challenge for anesthesia providers. Thus, a good understanding of the disease, its effects, as well as a thorough preoperative assessment, will be beneficial to formulate a personalized anesthesia plan to prevent unwanted consequences...