Cardiomyopathy is a disease in which the heart muscle becomes weakened, stretched, or has another structural problem. It often occurs when the heart cannot pump or function well. Most people with cardiomyopathy have heart failure.

There are many types of cardiomyopathy, with different causes. Some of the more common ones are:

• Dilated cardiomyopathy – a condition in which the heart becomes weak and the chambers get large. As a result, the heart cannot pump enough blood out to the body. It can be caused by many medical problems.
• Hypertrophic cardiomyopathy (HCM) – a condition in which the heart muscle becomes thick. This makes it harder for blood to leave the heart. This type of cardiomyopathy is most often passed down through families.
• Ischemic cardiomyopathy – caused by a narrowing of the arteries that supply the heart with blood. It makes the heart walls thin so they DO NOT pump well.
• Restrictive cardiomyopathy – a group of disorders. The heart chambers are unable to fill with blood because the heart muscle is stiff. The most common causes of this type of cardiomyopathy are amyloidosis and scarring of the heart from an unknown cause.
• Peripartum cardiomyopathy – occurs during pregnancy or in the first 5 months afterward.
• Arrhythmogenic right ventricular dysplasia – a rare type of cardiomyopathy in which muscle in the right ventricle is replaced by scar tissue and can lead to heart rhythm problems. It’s often caused by genetic mutations.
• Unclassified cardiomyopathy – all other types of cardiomyopathy fall into this category.

Often the cause of the cardiomyopathy is unknown. In some people, however, it’s the result of another condition or passed on from a parent.

Contributing factors for acquired cardiomyopathy include:

• Long-term high blood pressure
• Heart tissue damage from a heart attack
• Chronic rapid heart rate
• Heart valve problems
• Metabolic disorders, such as obesity, thyroid disease or diabetes
• Nutritional deficiencies of essential vitamins or minerals, such as thiamin
• Pregnancy complications
• Drinking too much alcohol over many years
• Use of cocaine, amphetamines or anabolic steroids
• Use of some chemotherapy drugs and radiation to treat cancer
• Certain infections, especially those that inflame the heart
• Iron buildup in your heart muscle (hemochromatosis)
• A condition that causes inflammation and can cause lumps of cells to grow in the heart and other organs (sarcoidosis)
• A disorder that causes the buildup of abnormal proteins (amyloidosis)
• Connective tissue disorders

Signs & Symptoms

When possible, the cause of cardiomyopathy is treated. Medicines and lifestyle changes are often needed to treat the symptoms of heart failure, angina and abnormal heart rhythms.

There might be no signs or symptoms in the early stages of cardiomyopathy. But as the condition advances, signs and symptoms usually appear, including:

• Breathlessness with exertion or even at rest
• Swelling of the legs, ankles and feet
• Bloating of the abdomen due to fluid buildup
• Cough while lying down
• Fatigue
• Heartbeats that feel rapid, pounding or fluttering
• Chest discomfort or pressure
• Dizziness, lightheadedness and fainting

Diagnosis

A Deborah Heart and Lung Center physician will conduct a physical examination, take a personal and family medical history, and ask when symptoms occur. The physician may order several tests to confirm the diagnosis, including:

• Chest X-ray
• Echocardiogram
• Electrocardiogram (ECG)
• Treadmill stress test
• Cardiac catheterization
• Cardiac MRI
• Cardiac CT scan
• Blood tests