Cardiomyopathy

What is cardiomyopathy?

Cardiomyopathy is a disease that affects your myocardium (heart muscle). Cardiomyopathy can make your heart stiffen, enlarge or thicken and can cause scar tissue. As a result, your heart can’t pump blood effectively to the rest of your body.

In time, your heart can weaken and cardiomyopathy can lead to heart failure. Treatment can help. Some people with cardiomyopathy eventually need a heart transplant.

Types of cardiomyopathy

Types of cardiomyopathy include:

• Dilated cardiomyopathy.
• Hypertrophic cardiomyopathy.
• Ischemic cardiomyopathy.
• Arrhythmogenic right ventricular dysplasia (ARVD).
• Restrictive cardiomyopathy.
• Transthyretin amyloidosis cardiomyopathy (ATTR-CM).
• Broken heart syndrome (stress-induced or takotsubo cardiomyopathy).
• Chemotherapy-induced cardiomyopathy.
• Alcohol-induced cardiomyopathy.
• Left ventricular non-compaction (LVNC).
• Peripartum cardiomyopathy.

How common is cardiomyopathy?

Cardiomyopathy can affect anyone of any age, sex or race. The most common inherited cardiomyopathy, hypertrophic, affects about 1 in 500 people in the world. Other genetic types occur in 1 in 2,000 or 2,500 people.

What are the symptoms?

Cardiomyopathy symptoms include:

• Fatigue.
• Heart palpitations.
• Chest pain.
• Arrhythmia.
• Shortness of breath (dyspnea).
• Swelling (edema) in your legs or ankles.
• Syncope (fainting).

Some people have no symptoms of cardiomyopathy and don’t need treatment. Others experience symptoms as their disease progresses.

What causes cardiomyopathy?

Causes of cardiomyopathy include genes you get from your parents. Researchers have found thousands of genetic mutations that cause cardiomyopathies.

Other cardiomyopathy causes include:

• Coronary artery disease.
• Autoimmune diseases, such as connective tissue diseases.
• Infections that affect your heart muscle.
• Heart inflammation.
• Diabetes.
• Thyroid disease.
• Muscular dystrophy.
• High cholesterol diseases.
• Sarcoidosis.
• Amyloidosis.
• Hemochromatosis.

Sometimes, experts don’t know the cause of a person’s cardiomyopathy.

What are the risk factors for cardiomyopathy?

Cardiomyopathy risk factors — some of which you can’t change — include:

• History of heart failure, cardiomyopathy or sudden cardiac arrest in your family.
• Personal history of heart attacks.
• Long-term use of cocaine or alcohol.
• Pregnancy.
• A highly stressful experience, such as the loss of a loved one.
• Radiation or chemotherapy to treat cancer.
• A body mass index (BMI) higher than 30.

What are the complications of cardiomyopathy?

As cardiomyopathy worsens, you may develop other heart problems, such as:

• Arrhythmias (irregular heartbeats).
• Heart failure.
• Stroke.
• Heart valve disease.
• Cardiac arrest.
• Cardiogenic shock.

How is cardiomyopathy diagnosed?

Your healthcare provider will ask about your medical history and that of your family. They’ll also do a physical exam.

If they suspect you have a heart condition, they’ll refer you to a cardiologist (heart specialist). A cardiologist performs a full assessment that may include a range of diagnostic tests.

What tests will be done to diagnose cardiomyopathy?

Tests to diagnose cardiomyopathy may include:

• Ambulatory monitoring.
• Blood tests.
• Chest X-ray.
• Cardiac CT.
• Heart MRI.
• Echocardiogram.
• Electrocardiogram (EKG).
• Exercise stress test.
• Cardiac catheterization.
• Myocardial biopsy.

How is cardiomyopathy treated?

Cardiomyopathy treatments don’t cure the condition. However, they can help you manage your symptoms and slow down the disease’s progression. Your healthcare provider may recommend lifestyle changes, medications, devices or procedures. They’ll decide your treatment based on which type of cardiomyopathy you have and how advanced it is.

Lifestyle changes

Changing how you live day-to-day can strengthen your heart. Ways to do this include:

• Eating food with low fat and salt.
• Staying at a weight that’s healthy for you.
• Getting regular exercise.
• Getting the amount of sleep you need.
• Reducing your stress level.
• Avoiding the use of tobacco products.
• Avoiding alcohol.

Medications

Depending on the cause, specific case, your cardiomyopathy and any other underlying medical conditions, certain medications can improve your blood flow and manage your symptoms.

Your cardiologist may prescribe:

• Antihypertensives.
• Blood thinners (anticoagulants).
• Antiarrhythmics.
• Medications to lower cholesterol.
• Aldosterone antagonists.
• Corticosteroids.

Devices to correct arrhythmias

Devices a provider puts into your body can treat irregular heart rhythms. These devices monitor your heartbeat. They send electrical impulses to your heart when an arrhythmia starts. You may receive one of these devices:

• Pacemakers.
• Implantable cardioverter defibrillators (ICDs).

Devices to improve blood flow

Some devices help your heart pump blood more efficiently. You may receive one of these devices:

• Cardiac resynchronization therapy (CRT).
• Left ventricular assist device (LVAD).

Procedures

If you have severe symptoms or underlying heart conditions, your provider may recommend a procedure. Some of these involve surgery. Providers usually only recommend open-heart surgery or a heart transplant when all other treatments have failed to bring relief. Most people with cardiomyopathy don’t need the procedures below.

Rarely used procedures may include:

• Septal myectomy.
• Heart transplant.
• Alcohol septal ablation.
• Catheter ablation.

How can I lower my risk of cardiomyopathy?

You can take action to reduce your risk of conditions that could lead to cardiomyopathy.

Some of these actions include:

• Managing your blood pressure.
• Keeping your cholesterol within healthy ranges.
• Getting regular exercise.
• Avoiding tobacco products, alcohol and cocaine.
• Managing underlying conditions such as sleep apnea or diabetes.
• Scheduling regular checkups with a healthcare provider.
• Taking all medications as prescribed.

You can’t prevent congenital (inherited) types of cardiomyopathy, but you can let relatives know that you have cardiomyopathy. Your relatives can talk to their providers to see if they’re at risk for it or have it. Early diagnosis helps people make a plan for managing cardiomyopathy.

What can I expect if I have cardiomyopathy?

Cardiomyopathy is a serious condition. Without treatment, it can be life-threatening. It’s also a progressive condition, meaning it usually worsens over time.

Cardiomyopathy treatment can improve your outlook. If you have cardiomyopathy, seek treatment from a cardiologist (heart specialist). Medication, procedures or other treatments can increase your quality of life and help you live longer.

How long cardiomyopathy lasts

The length of time that you have cardiomyopathy depends on the type you have. The severity of your condition matters, too. Takotsubo cardiomyopathy is usually temporary and doesn’t last long. Cardiomyopathy from alcohol may only last a few months. You may be able to reverse cardiomyopathy from chemotherapy.

For other types, you’ll need to manage your symptoms for the rest of your life. Many people don’t have major problems from their cardiomyopathy, but some do.

Outlook for cardiomyopathy

There’s no cure for cardiomyopathy. However, you can manage the condition or slow its progression. Many people who make healthy lifestyle choices and seek medical treatment can live a high quality of life with cardiomyopathy. Taking the proper medications can drastically alter and improve the prognosis of cardiomyopathy. Many people can live normal and healthy lives with the right treatment.

How do I take care of myself?

Lifestyle choices can affect how quickly cardiomyopathy progresses. To manage symptoms and increase your heart health, your provider may recommend:

• Achieving and maintaining an ideal weight for your height and age.
• Eating a heart-healthy diet, including reducing your sodium intake.
• Exercising regularly.
• Limiting alcohol intake.
• Managing and reducing stress.
• Quitting smoking.

When should I see my healthcare provider?

You’ll need regular checkups to monitor your heart’s health. Also, you may need regular blood tests or other tests that tell your provider how well your heart is doing. Contact your provider if you have:

• New symptoms.
• Worse symptoms.
• Side effects from medications.
• Trouble with your device.

When should I go to the ER?

Get emergency medical care if you have:

• Chest pain.
• Heart palpitations.
• Fainting.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• What’s the most likely cause of my cardiomyopathy?
• What treatments do you recommend?
• What lifestyle changes should I make to improve my heart health?
• Is there a support group nearby or online that I can join?

A note from Cleveland Clinic

It’s normal to have concerns about a cardiomyopathy diagnosis. But healthcare providers can offer many treatments to improve your quality of life and help you live longer. Ask your provider how often you need checkups with them. Going to regular appointments with your provider will help them monitor your condition and see how well treatments are working for you.