Cardiomyopathy Symptoms

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

Cardiomyopathy is a disease of the heart muscle. There are different types of this kind of heart disease, each with a unique set of symptoms. Understanding the symptoms can help with early detection and effective management.1

The types of cardiomyopathy are:2,3

  • Dilated cardiomyopathy
  • Hypertrophic cardiomyopathy
  • Arrhythmogenic cardiomyopathy
  • Restrictive cardiomyopathy

Symptoms of cardiomyopathy

People with cardiomyopathy may or may not show symptoms. The most common symptoms of cardiomyopathy are:1,4,5

  • Shortness of breath
  • Chest pain
  • Unexplained fatigue and tiredness
  • Dizziness or lightheadedness
  • Swelling of the legs, feet, or ankles
  • Coughing while lying down
  • Heart palpitations

Symptoms of dilated cardiomyopathy

With dilated cardiomyopathy, the heart gets larger. As a result, it weakens. The symptoms often develop gradually over time and may include:6

  • Fatigue
  • Weakness
  • Shortness of breath

As the disease progresses, fluid can collect in the lungs and other tissues. This can lead to swelling in the legs, ankles, and stomach. People may also have irregular heartbeats (arrhythmias) and chest pain.2,6

Symptoms of hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy occurs when the heart muscle thickens, especially the left ventricle. Symptoms may range from mild to severe. They can include:2,7

  • Shortness of breath
  • Chest pain
  • Fatigue
  • Dizziness

In some cases, people with hypertrophic cardiomyopathy may be prone to fainting, especially when active. Arrhythmias are common, too. Complications of this type include blood clots and sudden cardiac arrest (though this is rare).2,7

Symptoms of arrhythmogenic cardiomyopathy

Arrhythmogenic cardiomyopathy is a rare type of cardiomyopathy that mainly affects the right ventricle of the heart. Symptoms may include:2,8

  • Chest pain, especially during exercise
  • Heart palpitations
  • Arrhythmias
  • Fainting episodes

Arrhythmogenic cardiomyopathy is more common in men. It often affects teens and young adults. It is the most common reason for sudden death in young athletes.1,2

Symptoms of restrictive cardiomyopathy

Another rare type of cardiomyopathy is called restrictive cardiomyopathy. It occurs when the heart muscle stiffens. This restricts the heart's ability to relax, expand, and fill with blood. Symptoms often look like those of heart failure, such as:2,9

  • Fatigue
  • Swelling in the legs, feet, ankles, or stomach
  • Shortness of breath
  • Breathing problems, especially when lying down

People with this type of cardiomyopathy also may experience an enlarged liver and enlarged veins. Fluid may collect in areas like the hands, feet, and stomach.2,9

Diagnosing cardiomyopathy

Diagnosing cardiomyopathy typically involves a combination of a medical history review, physical exam, and special tests. Your doctor may ask about your symptoms, family history, and current medical conditions. A physical exam can also reveal signs of fluid buildup, irregular heartbeats, or abnormal heart sounds.10

The tests used to diagnose cardiomyopathy include:10

  • Electrocardiogram (ECG or EKG) – This test records the heart's electrical activity. It helps identify irregular heartbeats and abnormalities.
  • Echocardiogram – This imaging test uses sound waves to create a detailed image of the heart. This helps doctors see enlarged chambers, thickened walls, or other changes.
  • Magnetic resonance imaging (MRI) – An MRI also provides detailed images of the heart, allowing experts to look at its structure and function.
  • Blood tests – Blood tests may be conducted to look at cardiac enzymes. Enzyme levels can indicate heart muscle damage.
  • Holter monitor or event monitor – These portable devices record the heart's activity over an extended period. This helps capture irregular heartbeats that may not happen during a physical exam.

Stay on top of symptoms

Early diagnosis of heart disease is very important. Recognizing the symptoms of cardiomyopathy is necessary to get the right treatment as soon as possible. Tell your doctor about any new or unexplained symptoms.10

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