Cardiomyopathy

Cardiomyopathy (cardio-my-op-pa-thee) means disease of the heart muscle. It damages the muscle tone of your heart and reduces its ability to pump blood to the rest of your body.

Symptoms
Diagnosis
Treatment

Types

There are four main types of cardiomyopathy:

Dilated (congestive) cardiomyopathy
This is the most common form of cardiomyopathy. It affects the chambers of the heart by weakening their walls. It may be caused by a viral infection of the heart muscle, excessive alcohol consumption, cocaine and abuse of antidepressant drugs. In rare cases, it may be caused by pregnancy or connective tissue disease such as rheumatoid arthritis. But in most cases, the cause is unknown.

Hypertrophic cardiomyopathy
This causes a thickening of the heart's walls, which makes it harder for it to pump blood. In one form, the wall between the bottom chambers of the heart (the septum) becomes enlarged and blocks the flow of blood. It is usually an inherited disease, but sometimes the cause is not clear. It may occur as a birth defect but can affect people of all ages.

Restrictive cardiomyopathy
This condition restricts the heart from stretching properly, which limits the amount of blood that fills the heart's chambers. It is a rare type of cardiomyopathy.

Ischemic cardiomyopathy
Cardiac ischemia happens when an artery leading to your heart becomes narrowed or blocked for a short time and oxygen-rich blood cannot reach your heart. Ischemic cardiomyopathy is the loss or weakening of heart muscle tissue caused by ischemia (which causes chest pain called angina) or silent ischemia (which causes no pain). The ischemia usually results from coronary artery disease and heart attacks.

Symptoms

Some people have no signs and symptoms in the early stages of the disease. But as it develops, symptoms usually appear, which are often associated with congestive heart failure. Symptoms include:

Extreme fatigue
Breathlessness upon exertion (caused by fluid building up in the lungs)
Decreased physical stamina
Arrhythmias
Dilated (congestive) cardiomyopathy may cause swelling of the legs and abdomen, heart murmurs and the formation of blood clots in the heart
Hypertrophic cardiomyopathy may cause dizziness, fainting, heart murmurs and chest pain (angina)
Restrictive cardiomyopathy can cause swelling of the hands and feet

If you have one or more of these symptoms, see your doctor. Get immediate medical help if you experience chest pain or difficulty breathing.

How is cardiomyopathy diagnosed?

Diagnosing cardiomyopathy may require several tests. Any of the following may be required to make a firm diagnosis.

Angiography
Blood tests
Cardiac catheterization
Chest X-ray
Echocardiogram
Electrocardiogram (ECG)
Transesophageal echocardiogram

How is cardiomyopathy treated?

Your doctor may treat your cardiomyopathy by suggesting lifestyle changes, medications or surgery.

Lifestyle

You can lower your risk of heart disease by knowing and controlling your blood pressure, diabetes and blood cholesterol. It is also important to lead a healthy lifestyle by being smoke-free, physically active, eating a healthy diet that is lower in fat, especially saturated and trans fat, achieving and maintaining a healthy weight, limiting alcohol use and reducing your stress.

Medications

If the underlying cause of cardiomyopathy is known, it must be treated immediately with medications including:

ACE inhibitors
Beta blockers
Calcium channel blockers

Surgery

Surgery may be an option depending on what type of cardiomyopathy you have. Talk to your doctor to find out more about whether surgery can improve your condition. For a small percentage of patients with very advanced cardiomyopathy, a heart transplant may be necessary.

Last reviewed April 2007.