Cardiomyopathy is a progressive disease of the myocardium, or heart muscle. In most cases, the heart muscle becomes weakened and unable to pump blood to the rest of the body as well as it should. There are many different types of cardiomyopathy, caused by a range of factors from coronary heart disease to certain drugs. All these causes can lead to irregular heartbeats, heart failure, heart valve problems, and other complications.
Expert treatment and follow-up care are especially important to prevent heart failure or other complications.
Types of Cardiomyopathy
Generally, cardiomyopathy is classified into four general types.
The most common form, dilated cardiomyopathy (DCM) occurs when the heart muscle becomes too weak to pump blood effectively. The muscles stretch and become thinner, allowing the chambers of the heart to expand or “dilate.”
This is also called “enlarged heart,” and could be caused by coronary artery disease or could be inherited.
This type of cardiomyopathy is believed to be genetic. It results when the heart walls become thicker, preventing blood from flowing through the heart. About one in every 500 people has this form, making it a fairly common type of cardiomyopathy.
Arrhythmogenic Right Ventricular Dysplasia (ARVD)
A very rare form, ARVD is the leading cause of sudden death in young athletes. In this type of cardiomyopathy, the muscle of the right ventricle is replaced by fat and fibrosis (extra fibrous tissue), which causes abnormal heart rhythms. It’s believed to be of genetic origin.
The least common form, restrictive cardiomyopathy occurs when the ventricles become stiff and can’t relax enough to fill up with blood. This type may be caused by a scarring of the heart, which frequently occurs after a heart transplant. It can also occur as a result of heart disease.
Most of the following types of cardiomyopathy may be classified under one of the previous four, but each has unique causes or complications:
- peripartum: a rare form, this occurs when the heart weakens within five months of delivery or within the final month of pregnancy. (When it occurs after delivery, it’s sometimes called “postpartum cardiomyopathy.”) This is a form of dilated cardiomyopathy, and is a life-threatening condition of unknown cause.
- alcoholic: drinking too much alcohol over a long period of time can weaken the heart so it can no longer pump blood efficiently. The heart becomes enlarged—a form of dilated cardiomyopathy
- pediatric: the term used when cardiomyopathy affects a child
- idiopathic: any cardiomyopathy with no known cause
- ischemic: this term describes a heart that can no longer pump blood to the rest of the body due to coronary artery disease. Blood vessels to the heart become narrowed and blocked, depriving the heart muscle of oxygen. Ischemic cardiomyopathy is a common cause of heart failure
- non-ischemic: any form of cardiomyopathy not related to coronary artery disease
- noncompaction: a rare form, also called “spongiform cardiomyopathy,” is a congenital disease (present at birth) resulting from abnormal development of the heart muscle in the womb. Diagnosis may occur at any stage of life.
Regardless of the type of cardiomyopathy you may have, the symptoms tend to be similar. In all cases, the heart is unable to adequately pump blood to the tissues and organs of the body, resulting in symptoms such as:
- generalized weakness and fatigue
- shortness of breath, particularly during exertion or exercise
- lightheadedness and dizziness
- chest pain
- heart palpitations
- fainting attacks
- high blood pressure
- edema (swelling) of the feet, ankles, and legs
Treatment and Prognosis
Treatment varies depending on how much the cardiomyopathy has damaged the heart and the resulting symptoms.
Some people may require no treatment until symptoms appear. Others who are beginning to struggle with breathlessness or chest pain may need to make some lifestyle adjustments or take medications.
Cardiomyopathy can’t be reversed or cured, but it can be controlled with some of the following options:
- medications, including those used to treat high blood pressure, prevent water retention, keep the heart beating with a normal rhythm, prevent blood clots, and reduce inflammation
- surgically implanted devices, like pacemakers and defibrillators
- heart transplant (as a last resort)
Overall, the goal of treatment is to help the heart be as efficient as possible and to prevent further damage and loss of function.
Living with Cardiomyopathy
Cardiomyopathy can be life-threatening and can shorten life expectancy if severe damage occurs early on. The disease is also progressive, which means it tends to get worse over time. Fortunately, treatments can prolong life by slowing the degeneration of the heart’s condition or providing technologies to help the heart do its job.
Those with cardiomyopathy will typically be advised to make several lifestyle adjustments to safeguard the health of their hearts. These may include maintaining a healthy weight, eating a modified diet, limiting caffeine intake, getting enough sleep, and getting the support you need from family, friends, and healthcare providers.
Cardiomyopathy and Exercise
One of the biggest challenges often facing patients with cardiomyopathy is sticking with a regular exercise program. Exercise can be very tiring for someone with a damaged heart. However, exercise is extremely important to maintaining a healthy weight and prolonging the functioning of the heart. Therefore, it’s important to check with your doctor and engage in a regular exercise program that’s not too taxing, but that gets you moving every day.
The type of exercise that’s best for you will depend on the type of cardiomyopathy you have. Your doctor will help you determine an appropriate exercise routine and brief you on warning signs to watch out for while exercising.
HIV and Cardiomyopathy
An HIV infection can increase your risk of cardiomyopathy and heart failure—specifically, dilated cardiomyopathy. According to research, HIV, HIV treatments, and dietary and lifestyle factors can all increase risk of cardiomyopathy. If you have HIV, talk to your doctor about regular tests to check the health of your heart and follow a heart-healthy diet and exercise program.