Dilated Cardiomyopathy in Children: A Diverse Etiological Profile

Introduction Dilated cardiomyopathy (DCM) is the most common form of cardiomyopathy in children and represents a major cause of heart failure and mortality. Its etiological diagnosis often remains complex, particularly in resource-limited settings. Methods This was a retrospective descriptive study conducted over a 26‑month period (February 2024 to April 2026) in the pediatric department of the University Hospital of Tangier, Morocco. All children diagnosed with dilated cardiomyopathy were included. Clinical, etiological, and outcome data were analyzed. Results Among 40 cases of cardiomyopathy, 20 (50%) were dilated cardiomyopathy. The mean age was four years (range: two months to 13 years), with a male predominance (sex ratio = 1.8). All patients were symptomatic at diagnosis. The mean ejection fraction was 34.6%. Mitral regurgitation was observed in 70% of cases, and intracavitary thrombus in 5%. Identified etiologies included myocarditis (15%), genetic causes (15%), aortic coarctation (15%), chronic renal failure (10%), rickets-related hypocalcemia (10%), coronary anomalies (10%), and L‑carnitine deficiency (5%). No etiology was identified in 15% of cases. All patients received heart failure treatment. Mortality was 20%, while 65% of patients showed improvement in cardiac function during follow‑up. Conclusion Dilated cardiomyopathy in children remains a serious condition with multiple etiologies and a non‑negligible mortality rate. Early etiological investigation is essential to guide management and improve prognosis.