Nonischemic cardiomyopathy is when problems with your heart muscle aren’t due to reduced blood flow. Instead, causes include genetics, infections, and autoimmune conditions.

Cardiomyopathy is the medical term for problems with the heart muscle. Doctors often categorize these conditions according to their cause.

Ischemic cardiomyopathies are due to reduced blood flow to the heart. Common examples include narrowed arteries and heart attacks.

Nonischemic cardiomyopathies, on the other hand, aren’t due to reduced blood flow to the heart. Possible causes include viral infections and autoimmune conditions.

This article explores the symptoms, treatment, and outlook associated with some common types of nonischemic cardiomyopathy.

Your heart’s job is to pump blood to the rest of your body. A healthy heart pumps out 55–70% of the blood it contains each time it contracts.

When your heart pumps out more or less than that amount, it’s usually a sign of a problem. The problem might be ischemic or nonischemic. The most common cause of ischemic cardiomyopathy is coronary artery disease.

Common causes of nonischemic cardiomyopathy include:

Sometimes, the cause of nonischemic cardiomyopathy isn’t clear. This is known as idiopathic nonischemic cardiomyopathy.

Nonischemic cardiomyopathy may not cause any symptoms, or it can cause symptoms of heart failure or another heart problem. Those can include:

  • shortness of breath
  • swelling (edema) in the lower half of the body
  • sudden weight gain
  • weakness and fatigue
  • chest pain
  • dizziness and fainting
  • heart palpitations
  • irregular heartbeat (arrhythmia)

You might develop additional symptoms depending on the cause of your nonischemic cardiomyopathy. For example, people with nonischemic cardiomyopathy due to amyloidosis may also have nerve problems like carpal tunnel syndrome. Those with underlying inflammatory conditions may have other symptoms, like joint swelling or rash.

Your doctor will start by asking about your symptoms and medical history to learn more about your condition.

During a physical examination, they will listen to your heart and lungs and look for outward signs of cardiomyopathy, such as swelling in your legs and feet.

If they suspect cardiomyopathy, they may order additional tests. One of the main tests doctors use to detect cardiomyopathy is called an echocardiogram.

An echocardiogram is a type of ultrasound that produces a live image of the heart muscle as it contracts and relaxes. It can help your doctor see how well your heart is functioning.

Other tests for nonischemic cardiomyopathy can include:

The treatment for nonischemic cardiomyopathy depends on the cause, as well as your symptoms and the level of heart damage.

Sometimes, it can help to treat the underlying cause of nonischemic cardiomyopathy. If your case is mild, your doctor might suggest monitoring your condition, adopting a heart-healthy diet, and making lifestyle changes.

Your doctor might also prescribe medications. These can include the “four pillars” of heart failure therapy:

Additional medications may include

Some people require the use of a surgically implanted pacemaker or defibrillator to regulate an irregular heartbeat.

Nonischemic cardiomyopathy can increase your likelihood of severe complications, including:

Your outlook will depend on the cause of your nonischemic cardiomyopathy, along with factors such as your level of heart function and any other health conditions you might have.

In general, nonischemic cardiomyopathy tends to have a more positive outlook than ischemic cardiomyopathy.

The authors of a 2020 study compared 873 people with cardiomyopathy. They reported that the mortality rate and risk of sudden cardiac death were higher among people with ischemic cardiomyopathy than those with nonischemic cardiomyopathy.

Anyone can develop nonischemic cardiomyopathy, but it’s more common in females and younger people.

Some important risk factors include:

  • hypertension
  • a family history of cardiac arrest, cardiomyopathy, or heart failure
  • alcohol use disorder
  • amyloidosis
  • autoimmune conditions
  • certain medications
  • cocaine and other stimulant drugs
  • diabetes
  • hemochromatosis
  • obesity
  • sarcoidosis
  • thyroid disorders
  • viral infections, such as COVID-19, influenza, herpes, or HIV

It may not be possible to prevent nonischemic cardiomyopathy. The most you can do is take general precautions to avoid common viruses, such as washing your hands regularly and thoroughly.

It’s also important to make heart health a priority. You can try:

Talk with a healthcare professional to learn more about heart-healthy habits and lifestyle changes.

Here are answers to some frequently asked questions about nonischemic cardiomyopathy.

What’s the life expectancy of someone with nonischemic cardiomyopathy?

Nonischemic cardiomyopathy has many causes. Your life expectancy will depend on the cause and how well your heart is functioning.

Is nonischemic cardiomyopathy the same as heart failure?

Nonischemic cardiomyopathy is a type of heart muscle problem that’s not due to coronary artery disease, which is a common cause of heart failure. Nonischemic cardiomyopathy commonly causes heart failure, a condition in which the heart isn’t effectively supplying blood to the body.

Is nonischemic cardiomyopathy reversible?

It’s possible to recover some heart function (as measured by ejection fraction) in some types of nonischemic cardiomyopathy. For example, nonischemic cardiomyopathy due to chemotherapy is sometimes reversible. In other cases, making lifestyle changes or taking medications can help slow the progression of cardiomyopathy.

Nonischemic cardiomyopathy is an umbrella term for any cardiomyopathy that isn’t due to coronary artery disease.

It can be genetic. In other cases, it’s linked to another condition, such as a viral infection or an autoimmune condition.

A doctor will try to identify the cause when making a diagnosis. Your treatment may depend on what’s causing your cardiomyopathy.