Cardiomyopathy refers to heart muscle disease. The damaged heart does not effectively pump blood. The disease usually progresses to the point where patients develop life-threatening
. In addition, people with cardiomyopathy are more likely to have irregular heartbeats or
There are two major categories of cardiomyopathy: ischemic and nonischemic cardiomyopathy. Ischemic cardiomyopathy occurs when the heart muscle is damaged from
coronary artery disease
. Nonischemic cardiomyopathy, the less common category, includes types of cardiomyopathy that are not related to coronary artery disease.
There are three main types of nonischemic cardiomyopathy:
Dilated—Damaged heart muscles lead to an enlarged, floppy heart. The heart stretches as it tries to compensate for weakened pumping ability.
Hypertrophic—Heart muscle fibers enlarge abnormally. The heart wall thickens, leaving less space for blood in the chambers. Since the heart does not relax correctly between beats, less blood fills the chamber and is pumped from the heart.
Restrictive—Portions of the heart wall become rigid and lose their flexibility. Thickening often occurs due to abnormal tissue invading the heart muscle.
Symptoms vary, depending on the type of cardiomyopathy and its severity. Patients with hypertrophic cardiomyopathy often do not notice any symptoms. Sudden cardiac death may be the first indication of the condition. In dilated cardiomyopathy, it may take years for symptoms to develop. Blood clots may form due to the abnormal pooling of blood in the heart. If a clot moves to another part of the body (
), symptoms associated with that organ (the brain, for example) may be the first sign of the heart disease.
Cardiomyopathy ultimately leads to heart failure and the following symptoms:
Shortness of breath, often worse when lying down or with exertion
Swelling in feet or legs
Irregular heart rhythm
The doctor will:
Ask about your symptoms and medical history
Perform a physical exam
Listen to your heart with a stethoscope (Cardiomyopathies often produce heart murmurs and other abnormal heart sounds.)
—a test that records the heart's activity by measuring electrical currents through the heart muscle
—a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
Blood tests—to check for damage to the heart and other organs, and possibly the underlying cause(s) of the cardiomyopathy
—a tube-like instrument inserted into the heart through a vein or artery (usually in the arm or leg) to detect problems with the heart and its blood supply
—removal of a sample of heart tissue for testing
When heart failure is due to blockages in the coronary arteries, treatment directed at relieving these blockages through
coronary artery bypass surgery
may lead to improvements in heart function and symptoms. For certain genetic causes, other treatments may also lead to improvements in function. For many patients, however, treatment is aimed at relieving symptoms and prevent further damage.
Changes aim to eliminate anything that contributes to the disease or worsens symptoms:
If you are overweight, lose weight.
Eat a low-fat diet to minimize the risk and extent of coronary artery disease.
Limit salt intake to decrease fluid retention.
Follow your doctor's advice for exercise. You may need to limit physical activity.
Medications may include:
Diuretics—to eliminate extra fluid
ACE inhibitors—to help relax blood vessels, lower blood pressure, and decrease the heart's workload
Digitalis—to slow and regulate the heart rate, and modestly increase its force of contractions
Calcium channel blockers—to lower blood pressure and relax the heart
Beta blockers—to slow the heart and limit disease progression
Immune system suppressants—including steroids (depending on underlying cause)
Surgical options include:
may be implanted to improve the heart rate and pattern.
For patients with hypertrophic disease, doctors may remove part of the thickened wall separating the heart's chambers. Surgery may be needed to replace a heart valve.
may be possible for otherwise healthy patients who do not respond to medical treatment. Candidates often wait a long time for a new heart. Those waiting may temporarily receive a ventricular assist device, which is a mechanical pump that assumes some or most of the heart's pumping function.
Aggressively treating hypertension, coronary artery diseases, and their risk factors is the best way to prevent most cases of cardiomyopathy. Other, less common causes, however, are not preventable. People with a family history of the disease should ask the doctor about screening tests, especially before starting an intense exercise program.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a