Cardiomyopathy refers to diseases that affect the heart muscle, making it enlarged, thick or rigid. In some rare cases, heart tissue is replaced with scar tissue. The main types of cardiomyopathy include dilated, hypertrophic and restrictive cardiomyopathy. There is a rare type called Arrhythmogenic right ventricular dysplasia.
As cardiomyopathy worsens, the heart muscle weakens and becomes unable to properly circulate blood throughout the body and keep a normal electrical rhythm. This can cause heart failure or arrhythmia.
What causes cardiomyopathy?
Cardiomyopathy can be “acquired” due to another disease or “inherited” through your genes. There are four main kinds of cardiomyopathy, each caused by various disorders or genetic factors.
Dilated cardiomyopathy: The most common type, it causes the heart’s chambers to dilate and enlarge. Sometimes the exact cause is unknown, but certain diseases can cause it, including coronary artery disease, heart attack, high blood pressure, diabetes, thyroid disease, HIV and infection.
Hypertrophic cardiomyopathy: This occurs when the heart’s cells enlarge and thicken the walls of the ventricles. This kind is usually inherited but can also develop as a result of high blood pressure, diabetes or thyroid disease.
Restrictive cardiomyopathy: Affecting mostly older adults, this kind stiffens the ventricles and reduces the flow of blood through the heart. It’s usually caused by a buildup of iron in the blood (hemochromatosis), inflammation of certain organs (sarcoidosis), abnormal protein buildup in the body’s organs (amyloidosis), tissue disorders and some cancer treatments.
Arrhythmogenic right ventricular dysplasia: The rarest type, it causes scar tissue to replace the healthy tissue in the right ventricle, which causes arrhythmia. It’s most likely an inherited disease.
Symptoms of cardiomyopathy
Cardiomyopathy doesn’t always cause symptoms. As it progresses, you may notice the following signs that signal the beginning of heart failure:
- Shortness of breath
- Swelling in the ankles, feet, legs or abdomen
- Dizziness or lightheadedness
- Chest pain
- Poor exercise tolerance manifested as breathlessness with minimal exertion
How is cardiomyopathy diagnosed?
Your doctor will listen to your heart and lungs with a stethoscope to look for sounds that suggest cardiomyopathy.
The following tests and procedures can also help diagnose cardiomyopathy:
- Blood tests
- Cardiac catheterization
- Chest X-ray
- Coronary angiography
- Electrocardiogram (EKG)
- Genetic testing
- Holter and event monitors
- Myocardial biopsy
- Positron emission tomography (PET) scans
- Stress test
How is cardiomyopathy treated?
Sometimes cardiomyopathy requires no treatment at all and may go away on its own. Other times, treatment is necessary depending on the kind and severity that you have. The treatment varies depending on the type of cardiomyopathy present.
To manage a condition that’s causing cardiomyopathy, your doctor may recommend:
- Quitting smoking
- Eating a healthy diet
- Getting physical activity
- Reducing stress
- Avoiding alcohol and drugs
- Getting plenty of rest
- Treating high blood pressure or diabetes
- Taking medication to lower your blood pressure or heart rate, treat arrhythmia, balance electrolytes, prevent blood clots, or reduce inflammation
You may also require a surgery or medical procedure to treat cardiomyopathy, including:
- Alcohol septal ablation (a small portion of the thickened heart muscle is destroyed by injecting alcohol through a long, thin tube (catheter) into the artery supplying blood to that area)
- Septal myectomy (the surgeon removes part of the thickened heart muscle wall known as the septum that separates the two bottom heart chambers (ventricles). Removing part of the heart muscle improves functional blood flow through the heart and reduces mitral regurgitation)
- Left ventricular assist device (LVAD)
- Implantable cardioverter defibrillator (ICD)
- Heart transplant as a last resort