• Exclusion of potential common etiologies of dilated cardiomyopathy (familial; ischemic; alcohol; postpartum; cardiotoxic exposures) and the following: |
• Subacute or acute symptoms of heart failure refractory to standard management. |
• Substantial worsening of EF despite optimized pharmacological therapy. |
• Development of hemodynamically significant arrhythmias, particularly progressive heart block and ventricular tachycardia. |
• Heart failure with concurrent rash, fever, or peripheral eosinophilia. |
• History of collagen vascular disease such as systemic lupus erythematosus, scleroderma, or polyarteritis nodosum. |
• New-onset cardiomyopathy in the presence of known amyloidosis, sarcoidosis, or hemachromatosis. |
• Suspicion for giant cell myocarditis (young age, new subacute heart failure, or progressive arrhythmia without apparent etiology). |