These two conditions affect how well your heart can pump blood. Cardiomyopathy can sometimes lead to heart failure.

Cardiomyopathy and heart failure are both conditions in which your heart has a more difficult time pumping blood. While cardiomyopathy involves problems with your heart muscle specifically, heart failure can result from any number of heart complications, including valve and rhythm disorders.

Heart failure and cardiomyopathy both tend to worsen over time, raising the risk of serious or even life threatening complications. While they are similar, cardiomyopathy and heart failure differ in some important ways.

Among the main differences between cardiomyopathy and heart failure are their underlying causes, which affect the treatment options and the course of each disease.

Cardiomyopathy involves problems with your heart muscle that stem from an infection of heart tissue, overwork due to high blood pressure, or other causes. The muscle may thicken, become stretched, or contain unhealthy substances that affect its functioning.

Any of these problems can make your heart less efficient in pumping blood to all the organs, muscles, and other tissues in your body. If imaging, blood tests, and a physical examination reveal unhealthy changes to your heart muscle, a doctor will diagnose cardiomyopathy.

Heart failure, on the other hand, may or may not be the result of a heart muscle issue.

Conditions such as high blood pressure, valve disease, and arrhythmia (abnormal heart rhythm) can also trigger heart failure.

Over time, any condition that weakens your heart’s pumping ability may cause changes in your heart muscle. Heart failure often causes your heart muscle to work harder and thicken in order to compensate for its weakened pumping ability.

It’s a bit similar to the way your biceps grow larger if you put them through repeated workouts of curls and other resistance exercises.

The origins of certain types of cardiomyopathy and heart failure are also different. Children and young adults with cardiomyopathy usually have an inherited form of the condition. A diagnosis of heart failure in an infant or child usually results from a congenital heart issue.

The severity of symptoms in cardiomyopathy and heart failure may differ too.

It’s possible to have a mild case of cardiomyopathy that causes no obvious symptoms. This is one reason cardiomyopathy may be significantly underdiagnosed. The Centers for Disease Control and Prevention estimates that about 1 in 500 adults have this condition.

But cardiomyopathy often worsens even with treatment and lifestyle changes. As it gets worse, symptoms will develop.

Heart failure usually always has symptoms, regardless of its cause, though the symptoms may develop gradually. Around 2% of the overall population in the United States has heart failure, though that figure jumps to about 8.5% among adults ages 65–70 years.

Cardiomyopathy and heart failure share many symptoms, though the timing of certain symptoms can differ depending on which condition you have.

Heart failureCardiomyopathy
Chest painusually only if caused by a heart attackusually after exercise or a heavy meal
Dizzinessoften caused by heart medications or standing up too quicklycan occur at any time
Fatiguesometimes accompanied by muscle weaknessoften occurs after physical exertion
Irregular heart rhythmmay precede the development of heart failuremay result from changes in heart muscle cells that also affect your heart’s electrical system
Shortness of breathcan be worse when lying flat and may lead to coughing fitsusually worse after physical exertion
Swelling in lower limbscan indicate a rapid worsening of heart failure if it occurs suddenlymay indicate heart failure

Cardiomyopathy can be inherited or acquired. Acquired cardiomyopathy develops as the result of another condition. Some of the more common causes of acquired cardiomyopathy are:

  • certain autoimmune or connective tissue diseases
  • coronary artery disease or heart attack
  • endocrine problems such as thyroid disease and diabetes
  • excessive alcohol consumption
  • heart muscle infections
  • pregnancy

There are several types of cardiomyopathy, each with its own causes. The following sections discuss some of the main types.

Dilated cardiomyopathy (DCM)

DCM is the most common form of cardiomyopathy and usually develops in adults younger than 60 years old. It can be brought on by infections of the heart muscle, arrhythmias, heart attack, or other factors.

Hypertrophic cardiomyopathy (HCM)

HCM is a rare condition that is usually inherited from a parent. While it is a genetic disorder, it’s usually not diagnosed until adulthood.

Restrictive cardiomyopathy (RCM)

RCM is another rare form of cardiomyopathy. It’s most often caused by conditions such as cardiac amyloidosis, which is a buildup of the protein amyloid in heart tissue. Another cause is cardiac sarcoidosis, which happens when your body’s immune system causes lumps (granulomas) to form in your heart muscle.

Like the various cardiomyopathies, heart failure can develop as a result of many causes.

According to a 2019 report from the Heart Failure Association of the European Society of Cardiology, cardiomyopathies are frequent causes of heart failure, although there is still much to learn about how best to treat cardiomyopathies to better prevent them from progressing to heart failure.

Other common causes of heart failure include:

An early diagnosis and proper treatment can sometimes restore heart muscle health. According to a 2022 review, about 15% of people with dilated cardiomyopathy experience a return to normal heart size and function with treatment.

When changes in the structure and function of your heart muscle become so significant that your heart can no longer pump enough blood to meet your body’s demands, cardiomyopathy has developed into heart failure.

If you’ve received a diagnosis of cardiomyopathy but, despite a heart muscle problem, your heart can still pump enough blood throughout your body, you don’t yet have heart failure.

Though a heart attack is a common trigger for both cardiomyopathy and heart failure, you can have either one of the conditions without ever experiencing a heart attack or receiving a diagnosis of coronary artery disease.

The outlook for heart failure or cardiomyopathy depends on many factors, including the specific type of condition and its severity, as well as your age, your overall health, and what kind of treatment you’re receiving.

A 2022 study suggests that about 34% of people with DCM survive at least 15 years after diagnosis.

Heart failure life expectancy is usually determined by the stage of the disease and the person’s age. Typically, younger people who receive a diagnosis of heart failure have a better outlook.

A 2019 review of 60 small studies suggests that the average 10-year survival rate for someone with chronic heart failure is 34.9%.

Cardiomyopathy and heart failure are both conditions that affect your heart’s ability to pump blood throughout your body. While the two conditions are different in some ways, both are serious cardiac disorders that often require ongoing care to prevent potentially life threatening complications.

Working with a cardiologist and the rest of your healthcare team will give you the best chance at thriving with either or both of these heart conditions.