Cardiomyopathy

Reviewed by: HU Medical Review Board | Last reviewed: January 2024

Cardiomyopathy is a disease that damages the tissue in and around the heart. It leads to weakening, thickening, or stiffening of the heart muscle. This makes it harder for the heart to pump blood to the rest of the body.1-3

Cardiomyopathy can lead to heart failure, where the heart is unable to meet the body's demand for blood and oxygen. It can also lead to irregular heart rhythms called arrhythmias.1-3

There are many possible causes of cardiomyopathy, including genetics and stress. But in some cases, there is no known cause of cardiomyopathy.1-3

Types of cardiomyopathy

There are several types of cardiomyopathy. Each affects the heart slightly differently.4

Dilated cardiomyopathy

In people with this condition, the heart’s lower chambers (ventricles) get larger. This stretches and weakens the heart. As a result, the heart becomes unable to pump blood as it should.4

This is the most common form of cardiomyopathy. It is more common in Black people than white people. It is also more common in men than women.3,4

Hypertrophic cardiomyopathy

In people with hypertrophic cardiomyopathy, the heart muscle becomes a lot thicker than normal. This makes it harder for the heart to pump blood. This type of cardiomyopathy often goes undetected, but it can lead to complications like arrhythmias. Experts believe it to be the most common genetic heart disease.3,4

Arrhythmogenic cardiomyopathy

Arrhythmogenic cardiomyopathy is rare. In people with this condition, the normal heart muscle dies and is replaced with fatty or fibrous tissue. This raises the person’s risk of dying from a heart attack due to abnormal heart rhythms.4

This condition is more common in teens and young adults than in older adults. In fact, it is the most common cause of sudden death in young athletes.4

Restrictive cardiomyopathy

This type of cardiomyopathy involves stiffening of the heart muscles, which makes them less able to expand and fill with blood between heartbeats. The stiffness affects the heart's pumping capacity, leading to complications. This is a rare condition.4

Other rare types of cardiomyopathy include:1-6

  • Transthyretin amyloid cardiomyopathy (ATTR-CM) – Caused by abnormal protein deposits that build up in the heart tissue, leading to heart failure
  • Peripartum cardiomyopathy – Occurs during or after pregnancy
  • Takotsubo cardiomyopathy (or broken heart syndrome) – Caused by sudden extreme stress, like the death of a partner or spouse or infection

Who does cardiomyopathy affect?

Cardiomyopathy is a heart condition that can affect people of all ages, genders, and races. People with a family history of cardiomyopathy are at a higher risk. While some cases are inherited, others may result from:1-3

  • Viral infections
  • Heart conditions like coronary heart disease or heart attack
  • High blood pressure
  • Alcoholism
  • Other health conditions like diabetes and thyroid problems

Cardiomyopathy can occur in children, though it is very rare. About 1 in every 100,000 children under 18 in the United States is diagnosed with cardiomyopathy. Most children who are diagnosed are infants under the age of 1.7,8

What are the symptoms of cardiomyopathy?

The symptoms of cardiomyopathy can vary depending on the type. They can include:3

  • Fatigue
  • Shortness of breath
  • Swelling in the legs and ankles (edema)
  • Irregular heartbeat
  • Passing out or fainting (syncope)

How is cardiomyopathy diagnosed?

Early detection is vital for managing and treating cardiomyopathy. Diagnosis involves a combination of:1,5,7,8

  • Physical exam
  • Medical history
  • Blood tests
  • Diagnostic tests such as echocardiograms
  • Genetic testing

What are the treatment options for cardiomyopathy?

The goal of treatment is to slow down the disease, manage symptoms, and improve heart function. Treatment options include:1,3,8,9

  • Medicine – Depending on the type of cardiomyopathy, certain medicines are used to help improve heart function. These might include beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, or diuretics (water pills).
  • Lifestyle changes – Adopting a heart-healthy lifestyle can help. This means eating a balanced diet, exercising regularly, limiting alcohol intake, quitting smoking, and managing stress.
  • Device implants – In some cases, devices like pacemakers, left ventricular assist devices (LVADs), and implantable cardioverter defibrillators (ICDs) may be recommended. These devices regulate heart rhythm and prevent sudden cardiac arrest.
  • Surgery – In severe cases, or if other treatment methods do not work, a heart transplant may be needed.

What is the prognosis of cardiomyopathy?

Outcomes for people with cardiomyopathy can be unpredictable. A big part of each person's outcome depends on the type of cardiomyopathy, its severity, and how well the person responds to treatment.1,10

With early detection, proper treatment, and healthy lifestyle changes, many people with cardiomyopathy can lead fulfilling lives. However, if cardiomyopathy is severe or goes untreated, it can advance to heart failure and other life-threatening complications.10

Be sure to monitor your cardiomyopathy with regular checkups. Stick to your treatment plan unless otherwise directed by your doctor.10

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Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.