Cardiomyopathy: Types, Symptoms and How It Is Managed

Cardiomyopathy is a general term for diseases of the heart muscle. The heart's chamber walls may become stretched, thickened or stiff, which reduces its ability to pump blood. This article explains what the NHS says about the main types, causes and care.

What is cardiomyopathy?

The NHS says cardiomyopathy can affect people of any age. Most types are inherited, though other conditions and risk factors can be involved, and sometimes no cause is found.

The main types

The NHS describes these types:

• Dilated: the heart walls stretch and thin, so they cannot contract well. Risks include heart failure, valve problems, an irregular heartbeat and blood clots.
• Hypertrophic: heart muscle cells enlarge and the walls thicken, making the chambers smaller. Blood flow may be blocked. Most cases cause no daily impact, but it is the most common cause of sudden unexpected death in childhood and in young athletes. It affects about 1 in 500 people in the UK, the NHS says.
• Restrictive: rare, and most often diagnosed in children. Stiff walls stop the heart from filling properly.
• Arrhythmogenic: an inherited condition in which muscle cells are replaced by scar tissue, usually causing heart rhythm problems.
• Broken heart syndrome (Takotsubo): a temporary weakening of the heart after major emotional or physical stress such as bereavement or major surgery. It is more common in women, is reversible and rarely recurs, the NHS says.

Symptoms

The NHS does not give one list for all types. It says that heart failure from cardiomyopathy can cause shortness of breath, extreme tiredness and ankle swelling. Hypertrophic cardiomyopathy may cause dizziness, chest pain, breathlessness or a temporary loss of consciousness. Some types mainly cause heart rhythm problems. Broken heart syndrome causes chest pain and breathlessness that can feel like a heart attack.

Causes

According to the NHS, causes include:

• Inherited gene changes
• Underlying conditions such as sarcoidosis, amyloidosis, lupus and muscular dystrophy
• Uncontrolled high blood pressure
• Unhealthy lifestyle factors, such as poor diet, heavy alcohol use and recreational drugs
• A viral infection that inflames the heart muscle
• Heart valve problems
• Pregnancy, in rare cases (peripartum cardiomyopathy, during pregnancy or within 3 months of birth)

For many people the cause is unknown.

Diagnosis and treatment

Tests may include an ECG, echocardiogram, MRI scan, a 24- or 48-hour heart rhythm monitor, exercise tests, a detailed family tree and, sometimes, genetic testing. If a faulty gene is found, relatives can be offered testing too.

The NHS says there is usually no cure, but treatment can control symptoms and prevent complications, and early diagnosis matters. Some people with mild cases manage with lifestyle changes alone, such as healthy eating, gentle exercise, not smoking, a healthy weight, less alcohol, good sleep and stress management. Others need medicines for blood pressure, heart rhythm, fluid build-up or clot prevention, or procedures such as a pacemaker or implantable cardioverter defibrillator. A heart transplant is a last resort. Your specialist decides what is right for you. People with or at risk of arrhythmogenic cardiomyopathy should discuss exercise in detail with a cardiologist.

When to see a doctor

See a doctor if you have breathlessness, chest pain, dizziness, fainting, a very fast or irregular heartbeat, or a family history of cardiomyopathy or sudden unexplained death at a young age.

The NHS advises calling emergency services immediately if you or someone else has chest pain and breathlessness, because broken heart syndrome can look like a heart attack. Do not drive yourself to hospital.

In an emergency, call your local emergency number (112 in India, 911 in the United States).