- Cardiomyopathy is a disease of the heart muscle that worsens over time and can be life-threatening. The heart muscle weakens and can no longer pump blood effectively.
- Cardiomyopathy can result from an inherited genetic feature or it can stem from one of many health conditions, such as heart disease, hyperthyroidism, or alcohol use.
- Symptoms include weakness, dizziness, shortness of breath, high blood pressure, and fluid retention, or edema.
- Treatment options for cardiomyopathy include lifestyle changes, medications, and surgery.
Cardiomyopathy is a progressive disease of the myocardium, or heart muscle. In most cases, the heart muscle weakens and is 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. Cardiomyopathy can lead to an irregular heartbeat, heart failure, or other complications.
Medical treatment and follow-up care are important. They can help prevent heart failure or heart damage.
This article will take a closer look at the types of cardiomyopathy, as well as the symptoms, causes, and treatment.
Cardiomyopathy generally has four types:
- Dilated cardiomyopathy. Also sometimes called “enlarged heart,” dilated cardiomyopathy occurs when your heart muscle enlarges, or dilates, and may be too weak to pump blood efficiently. You can inherit it, or it can be the result of coronary artery disease. It’s the most common type of cardiomyopathy.
- Hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy, which is believed to be genetic, occurs when your heart walls thicken and prevent blood from flowing through your heart. This stiffens your heart and increases your risk of electrical problems. Long-term high blood pressure, aging, diabetes, or thyroid disease can also cause acquired types of hypertension-related cardiomyopathy. In some instances, the cause is unknown.
- Arrhythmogenic right ventricular dysplasia (ARVD). This is a very rare form of cardiomyopathy, but it’s the leading cause of sudden death in young athletes. In this type of genetic cardiomyopathy, fat and extra fibrous tissue replace the muscle of the right ventricle. This causes abnormal heart rhythms and abnormalities in the function of the right ventricle.
- Restrictive cardiomyopathy. Restrictive cardiomyopathy occurs when the ventricles stiffen and can’t relax enough to fill up with blood. Heart disease, scarring of the heart, and cardiac amyloid, which frequently occurs after a heart transplant, are thought to be possible causes.
Other types of cardiomyopathy
Most of the following types of cardiomyopathy belong to one of the previous four classifications, but each has unique causes or complications:
- Peripartum cardiomyopathy. Peripartum cardiomyopathy occurs during or after pregnancy. This rare type occurs when the heart weakens within 5 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 it’s a life threatening condition. Having it once increases your risk with other pregnancies.
- Alcoholic cardiomyopathy. Alcoholic cardiomyopathy is due to drinking too much alcohol over a long period of time, which can weaken your heart so it can no longer pump blood efficiently. Your heart can also become enlarged. This is a form of dilated cardiomyopathy.
- Ischemic cardiomyopathy. Ischemic cardiomyopathy occurs when your heart can no longer pump blood to the rest of your body due to coronary artery disease. Blood vessels to the heart muscle narrow and become blocked. This keeps oxygen from getting to the heart muscle. Ischemic cardiomyopathy is a common cause of heart failure. Alternatively, nonischemic cardiomyopathy is any form that isn’t related to coronary artery disease.
- Noncompaction cardiomyopathy. This is also known as spongiform cardiomyopathy. It’s a rare disease present at birth and is caused by abnormal development of the heart muscle in the womb. Diagnosis may occur at any stage of life.
- Pediatric cardiomyopathy. When cardiomyopathy affects a child, it’s called pediatric cardiomyopathy.
- Idiopathic cardiomyopathy. If you have idiopathic cardiomyopathy, it means the cause is unknown.
Q: Is hypertrophic cardiomyopathy dominant or recessive?
A: Hypertrophic cardiomyopathy is the most common genetic heart disorder.
It’s inherited in an autosomal dominant pattern. This means that only a single copy of the mutated gene is needed to cause the disorder.
Sarcomere gene mutations are the primary genetic cause of hypertrophic cardiomyopathy. Normally, sarcomere genes work to encode proteins that are responsible for helping the heart muscle contract and relax properly. A genetic mutation impairs the gene’s ability to function properly.
More than 2,000 sarcomere mutations have been identified to cause hypertrophic cardiomyopathy. However, not everyone who has a sarcomere gene mutation will develop this condition.Uzochukwu Ibe, MD, MPH, ABIM board certified internal medicine physician and general cardiologistAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
The symptoms of all types of cardiomyopathy tend to be similar. In all cases, the heart can’t adequately pump blood to the tissues and organs of the body. It can result in symptoms such as:
- general weakness and fatigue
- shortness of breath, particularly during exertion or exercise
- lightheadedness or dizziness
- chest pain
- heart palpitations
- fainting spells
- high blood pressure
- a bloated abdomen
- coughing when lying down
- edema, or swelling, of your feet, ankles, legs, or other body parts
According to the
- “Inherited” means that you‘re born with cardiomyopathy due to the genes you inherited from your parents.
- “Acquired” means that you developed cardiomyopathy due to a health condition, disease, or some other type of illness during the course of your life, such as:
- coronary artery disease
- heart tissue damage due to a heart attack
- infections in the heart muscle
Cardiomyopathy can affect people of all ages. Major risk factors include:
- a family history of cardiomyopathy, sudden cardiac arrest, or heart failure
- coronary artery disease
- chronic (long-term) high blood pressure
- damage to the heart due to a heart attack
- infections that cause inflammation of the heart
- heart valve disorders
- COVID-19 infection
- thyroid disease
- alcohol use disorder
- connective tissue disorders
- use of cocaine or amphetamines
- some types of cancer medications
- exposure to toxins, such as poison or heavy metals
If you have HIV, talk with a doctor about getting regular tests to check your heart’s health. You should also try to follow a heart-healthy diet and exercise program.
It’s possible to have cardiomyopathy and not have symptoms. But many people do develop some warning signs that their heart is weakening. If you notice any of these symptoms, it’s important that you contact your doctor as soon as possible:
- shortness of breath
- new or unusual fatigue
- swelling in your abdomen, legs, feet, ankles, or neck
- chest pain, especially after physical exertion or large meals
- passing out (fainting) during exercise or physical exertion
- an irregular heartbeat (arrhythmia)
If your doctor suspects you have a condition related to your heart, they may refer you to a cardiologist. This is a doctor who specializes in diagnosing and treating heart conditions.
Your doctor or cardiologist will incorporate the results of four components into your diagnosis:
- your personal medical history
- your family medical history
- physical examination
- diagnostic tests and procedures
The diagnostic tests and procedures your doctor or cardiologist may use include:
- Blood tests. Blood tests can provide information about your heart and also help rule out other conditions.
- Chest X-ray. A chest X-ray can help your doctor see the size and structure of your heart and lungs and check for any fluid buildup.
- Stress test. A stress test gauges your heart function while you exercise.
- Electrocardiogram. An electrocardiogram (EKG or ECG) is used to assess your heart’s electrical activity over a short period of time.
- Holter monitor. A Holter or event monitor can measure your heart’s electrical activity over 24 or 48 hours.
- Echocardiogram. An echocardiogram uses sound waves to create live images of your heart and how it’s beating.
- Heart MRI. A heart MRI uses magnets and radio waves to capture images of your heart and coronary blood vessels.
Your doctor may also perform some diagnostic procedures to confirm the diagnosis, especially if you’re planning to have surgery. These procedures may include:
- Cardiac catheterization. With cardiac catheterization, a long, thin tube is inserted into an artery or vein and threaded up to your heart so your doctor can evaluate your heart for a number of potential issues, including artery blockages.
- Coronary angiography. With coronary angiography, your doctor injects dye into your bloodstream to look at the flow of blood through your arteries and heart.
- Myocardial biopsy. A myocardial biopsy is a procedure that involves removing a small part of your heart’s tissue so it can be examined under a microscope.
Treatment varies depending on how damaged your heart is due to cardiomyopathy and the resulting symptoms.
Some people may not require treatment until symptoms appear. Others who are beginning to struggle with breathlessness or chest pain may need to make some lifestyle changes or take medications.
You can’t reverse or cure cardiomyopathy, but you can manage it with some of the following options:
- Heart-healthy lifestyle changes, such as aiming for a moderate weight, trying to quit if you smoke, following a balanced and nutritious diet, managing stress when possible, and getting the right amount of physical activity
- Medications, including medications 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
- Surgery, if symptoms are severe and medications don’t work well, bypass surgery or valve surgery may be an option. A less common procedure is septal myectomy, which involves removing some heart tissue in order to improve blood flow through the heart
- Heart transplant, which is considered a last resort
The goal of treatment is to help your heart work as efficiently as possible and to prevent further damage and loss of function.
If cardiomyopathy runs in your family, you may not be able to completely prevent it. But, you can take steps to keep your heart healthy and minimize the impact of this condition.
Even if cardiomyopathy isn’t part of your family history, it’s still important to take steps to make sure you don’t develop a heart condition or disease that could put you at an increased risk of cardiomyopathy.
- Getting regular exercise. Try to limit how much you sit each day, and focus on getting at least 30 minutes of exercise most days of the week.
- Getting enough sleep. Sleep deprivation is linked to an increased risk of heart disease. Try to get at least 7 to 8 hours of sleep each night.
- Eating a heart-healthy diet. Try to limit your intake of sugary, fried, fatty, and processed foods. Focus instead on fruits, vegetables, whole grains, lean proteins, nuts, seeds, and low fat dairy. Also limit your intake of salt (sodium), which can raise your risk of high blood pressure.
- Reducing your stress levels. Try to find healthy ways to lower your stress when possible. You may want to consider taking regular brisk walks, doing deep breathing exercises, meditating, doing yoga, listening to music, or talking with a trusted friend.
- Quitting smoking, if you smoke. Smoking can negatively affect your entire cardiovascular system, including your heart, blood, and blood vessels.
- Managing underlying health conditions. Work closely with your doctor to control and manage any underlying health conditions that may raise your risk of cardiomyopathy.
Cardiomyopathy can be life threatening and can shorten your life expectancy if severe damage occurs early on. The disease is also progressive, which means it tends to get worse over time, especially if it isn‘t treated.
Treatments can prolong your life by slowing the decline of your heart’s condition or by providing technologies to help your heart work more effectively.
If you have cardiomyopathy, it’s important to make lifestyle changes to improve your heart health, such as:
- eating a heart-healthy diet
- maintaining a moderate weight
- quitting smoking
- exercising regularly
One of the biggest challenges is sticking with a regular exercise program. Exercise can be very tiring for someone with cardiomyopathy. However, exercise is extremely important for maintaining a moderate weight and prolonging heart function.
It’s important to check with your doctor and engage in a regular exercise program that’s not too taxing but 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 can help you put together an exercise routine that’s safe and effective for you. They can also help you understand what signs and symptoms to watch out for while you’re exercising.
Cardiomyopathy is a progressive disease that involves the weakening of the heart muscle. If your heart weakens too much, it will be unable to pump blood properly to the organs and tissues throughout your body.
Cardiomyopathy can be caused by coronary artery disease, a heart attack, or some other underlying health condition. In some cases, it can be genetic, which means you inherited it from your parents. In other instances, the cause is unknown.
There are several types of cardiomyopathy, each with their own cause. The two most common types are dilated cardiomyopathy and hypertrophic cardiomyopathy.
Common symptoms of cardiomyopathy include shortness of breath, fatigue, and swelling in the feet, ankles, legs, abdomen, or veins of the neck.
If you notice any of these symptoms, contact your doctor as soon as possible. The sooner you can get treatment for this condition, the lower your risk of heart damage and loss of function.