Cardiomyopathy is a heart disease. The damaged heart does not pump blood correctly. The disease usually progresses, and patients develop life-threatening
. People with cardiomyopathy are also more likely to have irregular heartbeats or
There are two categories of cardiomyopathy: ischemic and non-ischemic. Ischemic cardiomyopathy is most common. It occurs when the heart is damaged from
coronary artery disease
. Non-ischemic cardiomyopathy is less common. It includes types of cardiomyopathy that are not related to coronary artery disease.
There are three main types of non-ischemic cardiomyopathy: Dilated—Damaged heart muscles lead to an enlarged, floppy heart. The heart stretches as it tries to make up for a weakened ability to pump.Hypertrophic—Heart muscle fibers enlarge abnormally. The heart does not relax correctly between beats. The heart wall thickens, leaving less space for blood to fill the chambers, so less blood is pumped from the heart.Restrictive—Parts of the heart wall stiffen. Thickening often occurs due to abnormal tissue invading the heart.
Normal Heart and Heart With Hypertrophic Cardiomyopathy
Copyright © Nucleus Medical Media, Inc.
In many cases, the exact cause is not known. Possible causes include:
The cause of the initial damage is often not found, but may include: Ischemic heart disease
with decreased blood flow to your heart
Infections, usually viral
Chronic exposure to toxins, including alcohol and some
A rare complication of pregnancy or childbirth (probably immune-related)
Rarely, other illnesses, including
Causes may include: Inherited (sometimes present at birth but often developing in teens)Aging, associated with hypertension
Causes are usually related to another condition, such as: Amyloidosis
—Protein fibers collect in the heart
—Small inflammatory masses (granulomas) form in many organs
—Too much iron in the body
Symptoms vary, depending on the type of cardiomyopathy and its severity.
Cardiomyopathy leads to heart failure and the following symptoms: FatigueWeaknessShortness of breath, often worse when lying down or with activityCoughSwelling in feet or legsChest painIrregular heart rhythm
Your doctor will ask about your symptoms and medical history. A physical exam will be done. A stethoscope will be used to listen to your heart. Cardiomyopathies often produce heart murmurs and other abnormal sounds.
Your doctor may need pictures of your chest. This can be done with:
Tests may be done to determine how your heart functions. These can be done with:
Your bodily fluids and tissue may need to be tested. This can be done with:
Heart failure may be due to blockages in the arteries. Treatments to relieve these blockages include
coronary artery bypass surgery
may lead to improved heart function and symptoms. For certain genetic causes, other treatments may also improve heart function. For many patients, however, treatment is aimed at relieving symptoms and preventing further damage.
Changes to eliminate anything that adds to the disease or worsens symptoms: Avoid alcohol.
If you are overweight,
Eat a low-fat diet to reduce the risk and extent of coronary artery disease.Limit salt intake to reduce fluid retention.
Follow your doctor's advice about
. You may need to limit physical activity.
Medications may include: Diuretics—To remove extra fluidAngiotensin-converting enzyme (ACE) inhibitors—To relax blood vessels, lower blood pressure, and decrease the heart's workloadAngiotensin receptor blockers—Similar to ACE inhibitorsHydralazine
isosorbide dinitrate—May be used with ACE inhibitorsDigitalis—To slow and regulate heart rate, and slightly increase its force of contractionsBeta-blockers—To slow the heart and limit disease progressionSpironolactone—To improve outcome in people with dilated cardiomyopathy and advanced symptoms
Surgical options include:
may be implanted to improve heart rate and pattern.
For people with hypertrophic disease, doctors may remove part of the thickened wall that separates the heart's chambers. Surgery may be needed to replace a heart valve. Another option is alcohol septal ablation. This procedure reduces symptoms and improves how the heart functions.
For those with life-threatening, irregular heart rhythms, a
may need to be implanted.
may be possible for otherwise healthy patients who do not respond to medical treatment. Candidates often wait a long time for a new heart. Those waiting may temporarily receive a ventricular assist device. This is a mechanical pump that takes over some of or most of the heart's pumping function.
Actively treat hypertension, coronary artery diseases, and their risk factors. This is the best way to prevent most cases of cardiomyopathy. However, other less common causes are not preventable. If you have a family history of the disease, ask your doctor about screening tests. Do this especially before starting an intense exercise program.
Braunwald E, Zipes DP, et al.
Heart Disease: A Textbook of Cardiovascular Medicine
6th ed. Philadelphia, PA: WB Saunders Company; 2001.
Echt DS, Packer D, et al. Multicenter unsustained tachycardia trial.
N Engl J Med
Heart Failure Society of America 2010 executive summary of heart failure practice guidelines.
J Card Fail
Last reviewed September 2013 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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