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. These can all lead to an irregular heartbeat, heart failure, a heart valve problem, or other complications.
Medical treatment and follow-up care are important. They can help prevent heart failure or other complications.
Cardiomyopathy generally has four types.
The most common form, dilated cardiomyopathy (DCM), occurs when your heart muscle is too weak to pump blood efficiently. The muscles stretch and become thinner. This allows the chambers of your heart to expand.
This is also known as an enlarged heart. You can inherit it, or it can be due to coronary artery disease.
Hypertrophic cardiomyopathy is believed to be genetic. It occurs when your heart walls thicken and prevent blood from flowing through your heart. It’s a fairly common type of cardiomyopathy. It can also be caused by long-term high blood pressure or aging. Diabetes or thyroid disease can also cause hypertrophic cardiomyopathy. There are other instances that the cause is unknown.
Arrhythmogenic right ventricular dysplasia (ARVD) 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.
Restrictive cardiomyopathy is the least common form. It occurs when the ventricles stiffen and can’t relax enough to fill up with blood. Scarring of the heart, which frequently occurs after a heart transplant, may be a cause. It can also occur as a result of heart disease.
Most of the following types of cardiomyopathy belong to one of the previous four classifications, but each has unique causes or complications.
Peripartum cardiomyopathy occurs during or after pregnancy. This rare type occurs when the heart weakens within five months of delivery or 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. There’s no cause.
Alcoholic cardiomyopathy is due to drinking too much alcohol over a long period, which can weaken your heart so it can no longer pump blood efficiently. Your heart then becomes enlarged. This is a form of dilated 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 deprives the heart muscle of oxygen. 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 also called spongiform cardiomyopathy, is a rare disease present at birth. It results from abnormal development of the heart muscle in the womb. Diagnosis may occur at any stage of life.
When cardiomyopathy affects a child, it’s called pediatric cardiomyopathy.
If you have idiopathic cardiomyopathy, it means there’s no known cause.
There might be no signs or symptoms in the early stages of cardiomyopathy. But as the condition advances, signs and symptoms usually appear, including:
Signs and symptoms tend to get worse unless treated. In some people, the condition worsens quickly; in others, it might not worsen for a long time.
See your doctor if you have one or more signs or symptoms associated with cardiomyopathy. Call 911 or your local emergency number if you have severe difficulty breathing, fainting or chest pain that lasts for more than a few minutes.
Because some types of cardiomyopathy can be hereditary if you have it your doctor might advise that your family members be checked.
Often the cause of the cardiomyopathy is unknown. In some people, however, it’s the result of another condition (acquired) or passed on from a parent (inherited).
Contributing factors for acquired cardiomyopathy include:
Your doctor will conduct a physical examination, take a personal and family medical history, and ask when your symptoms occur — for example, whether exercise brings on your symptoms. If your doctor thinks you have cardiomyopathy, you might need to undergo several tests to confirm the diagnosis, including:
The goals of cardiomyopathy treatment are to manage your signs and symptoms, prevent your condition from worsening, and reduce your risk of complications. Treatment varies by which type of cardiomyopathy you have.
Your doctor might prescribe medications to improve your heart’s pumping ability, improve blood flow, lower blood pressure, slow your heart rate, remove excess fluid from your body or keep blood clots from forming.
Be sure to discuss possible side effects with your doctor before taking any of these drugs.
Several types of devices can be placed in the heart to improve its function and relieve symptoms, including:
Other procedures used to treat cardiomyopathy or arrhythmia include:
Septal myectomy. In this open-heart surgery, your surgeon removes part of the thickened heart muscle wall (septum) that separates the two bottom heart chambers (ventricles). Removing part of the heart muscle improves blood flow through the heart and reduces mitral valve regurgitation.