IntroductionDilated cardiomyopathy (DCM) is "a syndrome characterized by cardiac enlargement and impairment of systolic function of one or both ventricles".4(1175) Through medical technology and an appropriate medical regimen, people Affected by this syndrome today, they live longer and undergo 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, the anesthetic effects it has, and a review of the current literature. Anatomy and Physiology Patients with dilated cardiomyopathy will often have normal thickness of the ventricles with an enlargement of the right, left, or both ventricular cavities. In the initial stages of this disease there is an initial increase in systolic volume due to the increased force of contraction due to stretching of the myocardium, described by the Frank-Starling mechanism. However, as the disease progresses, the heart loses that compensatory mechanism which leads to a decrease in the force of contraction of the heart, therefore to a decrease in the left ventricular ejection fraction. There are two types of DCM, primary and secondary. Primary dilated cardiomyopathy is usually idiopathic in nature, however, "approximately 30% of cases" have a "familial inheritance pattern". peripartum state, pheochromocytoma, infectious diseases (human immunodeficiency virus infection), uncontrolled tachycardia, Duchenne muscle...... middle of the document ......increased work of the heart. Conclusion Anesthesia management for patients with dilated cardiomyopathy is challenging. It is essential that a comprehensive preoperative assessment is performed to tailor the anesthetic plan specifically to the patient. Ensure that the patient has an optimized cardiac status and no symptoms of heart failure before elective surgeries because this increases morbidity and mortality. The anesthesiologist must be very vigilant throughout the perioperative period and timely administration of inotropes or antiarrhythmic drugs may be necessary. Patients with dilated cardiomyopathy represent a challenge for anesthetists, therefore, a good knowledge of the disease and its effects, together with an accurate preoperative evaluation, will be useful in formulating a personalized anesthetic plan to prevent adverse outcomes.