Dilated cardiomyopathy (DCM) is a primary myocardial disease characterized by left ventricular (LV) enlargement and global or segmental LV systolic dysfunction unexplainable by severity of obstructive Coronary artery disease (CAD) or abnormal loading condition such as hypertension, valvular heart disease or congenital heart disease. The latest ESC guideline suggested the morphological, structural description as a phenotypical approach for categorizing CMP and reaching the etiology. However, the classification of cardiomyopathy (CMP) is not uniform, and in some research trials, DCM is roughly categorized as the ischemic and nonischemic CMP. DCM includes a broad heterogeneous disease. It is important to classify CMP by integrated approaches, which include morphology, function, family history, ECG, and cardiac biomarkers, to find the etiology and appropriate therapeutic approach. Myocarditis frequently mimics acute coronary syndrome on the first presentation. Two-dimensional (2D) echocardiography, as the first imaging modality, has a restricted role in diagnosing acute myocarditis. Using advanced echocardiographic modalities such as strain and myocardial perfusion imaging has expanded the role of echocardiography for better diagnosis of regional and systolic contractility and myocardial blood flow.