Figure 2. Algorithm for the management of a patient with nonischemic DCM.

CMR: cardiac magnetic resonance, CK: creatine kinase. DCM patients should undergo an accurate family history examination. A comprehensive exam should include serum CK to evaluate skeletal muscle involvement. Genetic testing and genetic counseling should be offered to DCM patients, regardless of family history; 1^st degree relatives should be examined (physical exam, ECG, echocardiogram). A positive genetic testing in the proband offers the possibility of a confirmatory genetic testing in relatives, which may guide follow up and need of further testing. Adapted from^{14, 19, 140, 164}