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Disease: Cardiomyopathy Cardiomyopathy
Category: Cardiovascular diseases

Disease Definition:

The disease of the heart muscle is known as cardiomyopathy. The three main types of cardiomyopathy are dilated, hypertrophic and restrictive, and all of these types affect the heart's muscle, usually making it difficult to pump blood and deliver it to the rest of the body. Valvular heart disease and coronary artery disease are among the causes of cardiomyopathy.


Which type of cardiomyopathy the patient has and how serious it is are the things that determine the type of treatment one will receive, as cardiomyopathy can be treated. Surgically implanted devices, medications or even a heart transplant in severe cases may be included in the treatment options.

Work Group:

Symptoms, Causes


In the early stages of cardiomyopathy, some people who develop the disease may have no signs and symptoms. However, signs and symptoms usually appear as the condition advances. The following may be included in the signs and symptoms of cardiomyopathy:


  • Bloating (distention) of the abdomen with fluid
  • Dizziness, lightheadedness and fainting
  • Breathlessness with exertion or even at rest
  • Fatigue
  • Irregular heartbeats that feel fluttering,  pounding or rapid
  • Swelling of the legs, ankles and feet


Unless treated, signs and symptoms tend to get worse, no matter what type of cardiomyopathy one has. In some people, the disease may not worsen for a long time; while in others this worsening may happen quickly.


The cause of cardiomyopathy is not clear. However, doctors are able to identify some contributing factors in some people. Here are the possible causes of cardiomyopathy:


  • Pregnancy
  • Abuse of cocaine or antidepressant medications, such as tricyclic antidepressants
  • Heart tissue damage from a previous heart attack
  • Chronic rapid heart rate
  • Certain viral infections, which may injure the heart and trigger cardiomyopathy
  • Heart valve problems
  • Metabolic disorders, such as thyroid disease or diabetes
  • Excessive use of alcohol over many years
  • Long-term high blood pressure
  • Nutritional deficiencies of essential vitamins or minerals, such as magnesium, calcium, selenium and thiamin (vitamin B-1)
  • Use of some chemotherapy drugs to treat cancer

The disorder in which the body doesn’t properly metabolize iron, causing it to build up in various organs, including the heart muscle, is referred to as hemochromatosis. Resulting in dilated cardiomyopthy, this can lead to a weakening of the heart muscle.


Here are the three types of cardiomyoopathy:

Dilated cardiomyopathy:

In this disorder, which is the most common type of cardiomyopathy, blood doesn't flow as easily through the heart as the heart's main pumping chamber, the left ventricle, becomes enlarged and its pumping ability becomes less forceful. This type occurs most often in middle-aged people and men are more likely to be affected by it, although it can affect people of all ages. There might be a family history of the condition in the case of some people with dilated cardiomyopathy.

Hypertrophic cardiomyopathy:

Particularly affecting the muscle of the heart's main pumping chamber, abnormal growth or thickening of the heart muscle is involved in this type. Interfering with the heart's ability to deliver blood to the body, the heart tends to stiffen and the size of the pumping chamber may shrink as the thickening occurs.   Hypertrophic cardiomyopathy tends to be more severe if it becomes apparent during childhood, though it can develop at any age. Some genetic mutations have been linked to hypertrophic cardiomyopathy and most affected people have a family history of the disease.

Restrictive cardiomyopathy:

The heart can't properly expand and fill with blood between heartbeats, because the heart muscle in people with restrictive cardiomyopathy becomes rigid and less elastic. Restrictive cardiomyopathy most often tends to affect older people, but it can occur at any age. It can occur for no known reason (idiopathic) and it is the least common type of cardiomyopathy. A disease elsewhere in the body that affect the heart such as amyloidosis, a rare condition in which abnormal proteins present in the blood are deposited into the heart, may cause the condition as well.



The following complications may result from cardiomyopathy:

Heart failure:

This case means that the heart can't pump enough blood to meet the body's needs. The weakened, stiffened or thickened heart muscle due to cardiomyopathy can obstruct blood flow out of the heart or can become unable to pump.

Blood clots:

A person may become more susceptible to blood clots in the heart because of any of the types of cardiomyopathy. Clots can block the blood flow to vital organs including the heart and brain if these clots are pumped out of the heart and enter the circulatory system. Clots may travel to the lungs if they develop on the right side of the heart. A blood thinner (anticoagulant medication), such as clopidogrel, warfarin or aspirin may be prescribed to reduce the risk of having blood clots.

Heart murmur:

Leading to a backflow of blood, two of the four valves of the heart– the mitral and tricuspid valves – may not close properly in the case of people with dilated cardiomyopathy because they have an enlarged heart. The sounds that are called heart murmurs are created by this flow. Heart murmurs should be monitored by the doctor though they are not necessarily harmful.

Cardiac arrest and sudden death:

Abnormal heart rhythms can be caused by all forms of cardiomyopathy. Some of these heart rhythms are too fast to allow the heart to beat properly and some are too slow to sustain the circulation. These abnormal heart rhythms can result in fainting in either case, or sudden death from a complete cessation of heartbeats, called cardiac arrest, in some cases.


Reducing the risk of complications, preventing the condition of the patient from worsening and managing the signs and symptoms are the overall goals of treatment of cardiomyopathy. The type of cardiomyopathy a person has will determine his/her treatment.



Medications, surgically implanted devices, or a combination of both may be recommended for a person diagnosed with dilated cardiomyopathy. Here are the medications he/she may be prescribed:


  • Beta blockers to improve heart function such as metoprolol and carvedilol.
  • Angiotensin-converting enzyme (ACE) inhibitors to improve the heart's pumping capability, such as ramipril, lisinopril, captopril or enalapril.
  • For those who can't take ACE inhibitors, angiotensin receptor blockers (ARBs), such as valsartan and losartan.


A special pacemaker that coordinates the contractions between the left and right ventricle (biventricular pacing) is another option for some people with dilated cardiomyopathy. An implantable cardioverter-defibrillator (ICD) or drug therapy could be options in people who may be at risk of serious arrhythmias. ICDs are small devices — about the size of a box of matches — implanted in the chest of the patient to control abnormal, rapid heartbeats by delivering electrical shocks when needed and to monitor the heart rhythm continuously. These devices can work as pacemakers as well.



To stabilize the rhythm of the heart, slow its pumping action and relax it, beta blockers or calcium channel blockers such as verapamil are included in these medications.


A pacemaker or an ICD may be recommended in some cases. A portion of the thickened muscle wall that blocks normal blood flow may be removed in advanced cases of hypertrophic cardiomyopathy. In most cases, symptoms can be reduced by this procedure that is called septal myotomy-myectomy.


A new therapy called alcohol ablation, which uses injected alcohol to destroy extra heart muscle, may be recommended as well. Muscle thickening may be reduced and blood flow may be improved by this nonsurgical procedure.



Improving symptoms is the thing that treatment for restrictive cardiomyopathy focuses on. The patient should monitor his/her weight daily and pay careful attention to his/her salt and water intake. If sodium and water retention becomes a problem, the patient may be recommended taking diuretics. To control fast or irregular heart rhythms and lower blood pressure, certain medications may be prescribed for the patient.


There may be side effects for many of the medications that doctors prescribe for cardiomyopathy. So before taking any of these drugs, the patient should discuss these possible side effects with the doctor.



A heart transplant may be an option if the patient has severe cardiomyopathy and medications can't control his/her symptoms. Before having a heart transplant, even people who are critically ill may have a long wait because of the shortage of donor hearts. As critically ill people wait for an appropriately matched donor, a mechanical heart assist device can help them in some cases. The circulation of the patient can be supported for a prolonged period and the patient may be allowed to live outside the hospital while he/she waits thanks to these devices known as ventricular assist devices (VADs). VAD therapy may provide long-term support in some people who aren't candidates for a heart transplant.


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