Cardiomyopathy is a heart disease. The damaged heart does not pump blood correctly. The disease usually progresses, and patients develop life-threatening
heart failure. People with cardiomyopathy are also more likely to have irregular heartbeats or arrhythmias.
There are two categories of cardiomyopathy: ischemic and non-ischemic. Ischemic cardiomyopathy is most common. It occurs when the heart is damaged from
coronary artery disease. Non-ischemic cardiomyopathy is less common. It includes types of cardiomyopathy that are not related to coronary artery disease.
There are three main types of non-ischemic cardiomyopathy:
Dilated—Damaged heart muscles lead to an enlarged, floppy heart. The heart stretches as it tries to make up for a weakened ability to pump.
Hypertrophic—Heart muscle fibers enlarge abnormally. The heart does not relax correctly between beats. The heart wall thickens, leaving less space for blood to fill the chambers, so less blood is pumped from the heart.
Restrictive—Parts of the heart wall stiffen. Thickening often occurs due to abnormal tissue invading the heart.
Normal Heart and Heart With Hypertrophic Cardiomyopathy
You will be asked about your symptoms and medical history. A physical exam will be done. A stethoscope will be used to listen to your heart. Cardiomyopathies often produce heart murmurs and other abnormal sounds.
Images of your chest may be needed. This can be done with:
Heart failure may be due to blockages in the arteries. Treatments to relieve these blockages include
stent placement, and
coronary artery bypass surgery. These may lead to improved heart function and symptoms. For certain genetic causes, other treatments may also improve heart function. For many patients, however, treatment is aimed at relieving symptoms and preventing further damage.
Changes to eliminate anything that adds to the disease or worsens symptoms:
If you are overweight,
talk to your doctor about ways to help you lose weight.
Eat a low-fat diet to reduce the risk and extent of coronary artery disease.
Limit salt intake to reduce fluid retention.
Follow your doctor's advice about
exercise. You may need to limit physical activity.
Medications may include:
Diuretics—To remove extra fluid
Angiotensin-converting enzyme (ACE) inhibitors—To relax blood vessels, lower blood pressure, and decrease the heart's workload
Angiotensin receptor blockers—Similar to ACE inhibitors
isosorbide dinitrate—May be used with ACE inhibitors
Digitalis—To slow and regulate heart rate, and slightly increase its force of contractions
Beta-blockers—To slow the heart and limit disease progression
Spironolactone—To improve the outcome in people with dilated cardiomyopathy and advanced symptoms
may be implanted to improve heart rate and pattern.
For people with hypertrophic disease, doctors may remove part of the thickened wall that separates the heart's chambers. Surgery may be needed to replace a heart valve. Another option is alcohol septal ablation. This procedure reduces symptoms and improves how the heart functions.
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. This is a mechanical pump that takes over some or most of the heart's pumping function.
Actively treat hypertension, coronary artery diseases, and their risk factors. This is the best way to prevent most cases of cardiomyopathy. However, other less common causes are not preventable. If you have a family history of the disease, ask your doctor about screening tests. Do this especially before starting an intense exercise program.