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Understanding cardiomyopathy can help you find the right treatment

Cardiomyopathy is a collection of conditions that affect the heart muscle and reduce the heart’s ability to pump blood effectively. Up to 1 in 500 adults may have the condition, but it often goes undiagnosed.

All cardiomyopathies interfere with blood flow from the heart to the rest of the body. But the exact issue with pumping blood out of the heart can differ. Possible problems include:

  • Heart muscle scarring or stiffening
  • The heart filling with a substance other than blood
  • Thickening or thinning of the heart muscle

These issues may lead to heart failure or sudden cardiac arrest, where the heart stops pumping unexpectedly.

Types of cardiomyopathies

​​​​​​​​​​​​​Types of cardiomyopathies include:

Arrhythmogenic cardiomyopathy

This type causes irregular heartbeat or rhythm (arrhythmia).

Dilated cardiomyopathy

One of the two lower heart chambers responsible for pumping blood is enlarged.

Hypertrophic cardiomyopathy

This type involves the thickening of the heart muscle.

Peripartum cardiomyopathy

A rare type of heart failure, peripartum cardiomyopathy happens late in pregnancy or within a year of giving birth.

Restrictive cardiomyopathy

This occurs when the heart muscle becomes scarred or stiff.

Takotsubo cardiomyopathy

Also called broken heart syndrome, this type happens in response to extreme stress.

Transthyretin amyloid cardiomyopathy

This type happens when a specific protein builds up in the heart.

Cardiomyopathy symptoms

Some people never experience symptoms of this condition. In others, cardiomyopathy symptoms may appear or worsen as the condition progresses.

Possible cardiomyopathy symptoms include:

  • Angina (chest pain), especially after physical activity or eating a large meal
  • Arrhythmia
  • Extreme tiredness
  • Dizziness or lightheadedness
  • Fainting
  • Shortness of breath or trouble breathing
  • Swelling in the abdomen, ankles, feet or legs

What causes cardiomyopathy?

The cause of cardiomyopathy is often unknown, but several possible factors can be involved, including:

Cardiomyopathy risk factors

Cardiomyopathy can affect people of all ages, but some types are more common at certain stages of life. For example, arrhythmogenic cardiomyopathy often affects teens or young adults. In contrast, hypertrophic cardiomyopathy is more likely to affect people in their 30s.

Similarly, certain types are more common in men, and others tend to affect women.

You may be at higher risk for cardiomyopathy if you have any of the following risk factors:

  • Diabetes
  • Family history of cardiomyopathy, heart failure or sudden cardiac arrest
  • High stress levels
  • History of chemotherapy or radiation treatments 
  • Infection in the heart muscle
  • Obesity
  • Regular alcohol use
  • Thyroid disease
  • Use of illegal drugs such as cocaine or methamphetamines

Diagnosing cardiomyopathy

​​​​​​​​​​​​​Your healthcare provider may recommend diagnostic tests if they notice symptoms or if you have a close family member with cardiomyopathy. These tests can confirm if you have cardiomyopathy or rule out other conditions with similar symptoms.
  • Blood tests

    Blood tests

    Blood tests measure for specific proteins in the blood that help keep blood pressure stabilized.

  • Electrocardiogram (EKG or ECG)

    Electrocardiogram (EKG or ECG)

    An electrocardiogram tracks the electrical signals in the heart to monitor its health and functionality.

  • Imaging tests

    Imaging tests

    Imaging tests like coronary angiograms take X-rays of the heart’s blood vessels to scan for blockages.

  • Genetic testing or screening

    Genetic testing or screening

    You may have access to genetic counseling programs that can help assess your likelihood of having an increased risk of cardiomyopathy. Talk to your doctor to see if this is an option for you.

Blood tests

Blood tests measure for specific proteins in the blood that help keep blood pressure stabilized.

Electrocardiogram (EKG or ECG)

An electrocardiogram tracks the electrical signals in the heart to monitor its health and functionality.

Imaging tests

Imaging tests like coronary angiograms take X-rays of the heart’s blood vessels to scan for blockages.

Genetic testing or screening

You may have access to genetic counseling programs that can help assess your likelihood of having an increased risk of cardiomyopathy. Talk to your doctor to see if this is an option for you.

Cardiomyopathy treatment options

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Some types of cardiomyopathy don’t require treatment if they aren’t causing symptoms. Certain kinds may also go away on their own.

If you need treatment for your cardiomyopathy, your cardiologist will work with you to develop a care plan to:

  • Improve your quality of life
  • Keep the condition from worsening
  • Manage symptoms
  • Prevent serious complications, including sudden cardiac arrest
  • Treat an underlying health condition causing cardiomyopathy

Depending on the type of cardiomyopathy you have, treatment might include a combination of lifestyle changes, medication, medical procedures or surgery.

  • Lifestyle changes

    Lifestyle changes

    You may be able to manage certain types of cardiomyopathy with lifestyle changes, such as:

    • Avoiding alcohol and illegal drugs
    • Eating a healthy diet
    • Exercising regularly
    • Getting enough sleep
    • Limiting certain activities
    • Learning new ways to manage stress
    • Taking steps to manage chronic health conditions
    • Quitting smoking
  • Medication

    Medication

    Your cardiologist may recommend medication to manage or treat cardiomyopathy, including prescription drugs that:

    • Balance minerals in the body (called electrolytes)
    • Decrease inflammation
    • Lower blood pressure
    • Prevent blood clots
    • Remove excess fluid
    • Slow heart rate
  • Surgery and procedures

    Surgery and procedures

    When cardiomyopathy can’t be treated through lifestyle changes and medication, your cardiologist may recommend a medical procedure or surgery, such as:

    • Alcohol septal ablation: During this nonsurgical procedure, a type of alcohol is injected into a blood vessel that brings blood to the heart. The alcohol causes the muscle dividing the lower heart chambers to shrink, improving blood flow.
    • Catheter ablation: This nonsurgical procedure uses extreme temperatures, laser light or radiofrequency waves to reroute electrical signals in the heart.
    • Septal myectomy: During this open-heart surgery, your surgeon removes a part of the muscle dividing the lower heart chambers to improve blood flow.
    • Surgery to implant a device: Medical devices, such as a cardioverter defibrillator, left ventricular assist devices and pacemakers, can improve how your heart works by monitoring your heart rate or managing your heart rhythm.
    • Heart transplant: Generally used only for people with life-threatening complications, you may need a heart transplant if the treatments above aren’t successful.

Lifestyle changes

You may be able to manage certain types of cardiomyopathy with lifestyle changes, such as:

  • Avoiding alcohol and illegal drugs
  • Eating a healthy diet
  • Exercising regularly
  • Getting enough sleep
  • Limiting certain activities
  • Learning new ways to manage stress
  • Taking steps to manage chronic health conditions
  • Quitting smoking

Medication

Your cardiologist may recommend medication to manage or treat cardiomyopathy, including prescription drugs that:

  • Balance minerals in the body (called electrolytes)
  • Decrease inflammation
  • Lower blood pressure
  • Prevent blood clots
  • Remove excess fluid
  • Slow heart rate

Surgery and procedures

When cardiomyopathy can’t be treated through lifestyle changes and medication, your cardiologist may recommend a medical procedure or surgery, such as:

  • Alcohol septal ablation: During this nonsurgical procedure, a type of alcohol is injected into a blood vessel that brings blood to the heart. The alcohol causes the muscle dividing the lower heart chambers to shrink, improving blood flow.
  • Catheter ablation: This nonsurgical procedure uses extreme temperatures, laser light or radiofrequency waves to reroute electrical signals in the heart.
  • Septal myectomy: During this open-heart surgery, your surgeon removes a part of the muscle dividing the lower heart chambers to improve blood flow.
  • Surgery to implant a device: Medical devices, such as a cardioverter defibrillator, left ventricular assist devices and pacemakers, can improve how your heart works by monitoring your heart rate or managing your heart rhythm.
  • Heart transplant: Generally used only for people with life-threatening complications, you may need a heart transplant if the treatments above aren’t successful.