All patients in this study will be subjected to the following (as detailed in the attached patient's data sheet).
1. Clinical History: focusing on:
* Socio-demographic factors, especially age, gender, family history, and degree of consanguinity.
* Cardiac symptoms, such as feeding difficulties in the infant, exercise intolerance in older children, fatigue, dyspnea on exertion, heart failure symptoms.
2. Thorough clinical examination: focusing on:
* General condition.
* Anthropometric measures (weight, height, and body mass index).
* Vital signs (Including HR, BP, SO2, RR, Body temperature).
* Cardiac examination (including any associated murmur, signs up heart failure).
3. Severity of heart failure in children with dilated cardiomyopathy For all patients, they were classified according to Children's Ross HF classification.
Children's Ross HF classification is as follows\[17\]:
Class I: asymptomatic cases.
Class II: mild tachypnea or diaphoresis with feeding in infants, dyspnea on exertion in older children.
Class III: marked tachypnea or diaphoresis with feeding in infants, marked dyspnea on exertion, and prolonged feeding times with growth failure.
Class IV: tachypnea, retractions, grunting, or diaphoresis at rest are examples of symptoms.
4. Data collection: according to attached checklist for every patient involved in the study