The most prominent clinical features of dilated cardiomyopathy are the following: i. Congestive heart failure is the most prominent manifestation, with shortness of breath and swelling being the most common. It is mainly due to decreased ventricular contractility, reduced compliance, insufficient cardiac output due to fluid retention and high ventricular filling pressures. Patients exhibit telangiectatic breathing, paroxysmal dyspnea, and in late stages, right heart failure manifestations such as hepatomegaly and peripheral edema may also occur. Second, arrhythmias, which can occur as a variety of rapid or slow arrhythmias, or even as the first clinical manifestation of the disease, and severe arrhythmias are a common cause of sudden death. Embolism, can occur in the heart, brain, kidney, lung embolism, thrombus mainly from the enlarged ventricles or atria, especially with atrial fibrillation, peripheral vascular embolism occasionally for the common manifestation of the disease. Fourth, chest pain, which occurs in about one-third of patients, may be related to pulmonary hypertension, pericardial involvement, and microvascular myocardial ischemia.