Hello! Thank you for contacting on HCM! Regarding your concern, I would explain that an enlarged heart (ventricle(s)); that is a dilated cardiomyopathy, may be a final natural conclusion of several pathological processes involving the heart (valvular, ischemic, myocardial, infectious, etc. disorders). When dealing with the evaluation of a dilated cardiomyopathy, the two main issues to consider are: (1) severity of cardiac function impairment in terms of abnormal LV ejection fraction lowering, and adverse ventricular myocardial remodelling, and (2) persistence of etiological factort and its triggered pathological processes. The main goasl to achieve in a dilated cardiomyopathy are: (a) To completely relieve (if possible) the etiological triggering factor, (b) Impede as much as possible pathological myocardial remodeling, thus stopping further dilation, (c) Preventing potential cardiac and systemic complications derived by dilated cardiomyopathy (clinical signs and symptoms of heart failure, like congestion, excess fatigue, several arrhythmias, etc). Facing your actual condition, you need to discuss with your cardiologist about possible triggering factors of actual cardiopathy (in order to avoid them)., and to implement an ongoing therapy as you demonstrate heart failure symptomatology (fatigue, etc). Regarding the interventional digestive procedure, I would explain that though you have a dilated cardiomyopathy, there are no contraindications for colonoscopy, as far as you have implemented an appropriate management strategy for heart failure. These diagnostic procedures ar performed through a light sedation, which is not harmful for the heart. So I recommend to discuss with your cardiologist about the above mentioned issues. Hope to have been helpful! Greetings! Dr. Iliri