The heart is the first organ to form and to function during vertebrate embryogenesis and its correct functionality is a "conditio sine qua non" for life. If the heart's pumping power is compromised, chambers dilate and pulmonary and systemic circulations are altered. Dilated cardiomyopathy can appear along a wide spectrum of presentations, including no symptoms, subtle symptoms or heart failure, which occurs when the heart is unable to pump blood to the periphery and oxygenate the organs. Dilated cardiomyopathy, the most common form of cardiomyopathy, is characterized by a particular complex of nonspecific pathologic features that do not necessarily identify the different etiologies. In this study, we review the etiologic and morphologic features of 86 explanted recipient adult hearts with dilated cardiomyopathy undergoing orthotopic heart transplantation between 1997 and 2008.