Cardiomyopathy overview

Overview

Cardiomyopathy is a disease of the heart muscle. The heart becomes enlarged, thick, or stiff, so it cannot pump blood as well as it should. There are different types, but all affect the heart's ability to work properly.

Cardiomyopathy is not very common, but it is a serious condition. It affects about 1 in every 500 people.

Anyone can get cardiomyopathy, but some types are more common in certain age groups or in people with a family history of the condition. It can also occur as a result of other diseases.

Symptoms

Common symptoms

• Shortness of breath, especially during activity or when lying down
• Extreme tiredness (fatigue)
• Swelling in the legs, ankles, or feet
• Heart palpitations (feeling like your heart is pounding or fluttering)
• Dizziness or lightheadedness
• Fainting (syncope)

Symptoms in children

• Poor feeding and slow growth
• Rapid breathing or excessive sweating
• Being unusually tired or irritable

Symptoms in older adults

• Shortness of breath that is often mistaken for normal aging
• Fatigue and weakness
• Swelling in the lower body
• Coughing, especially when lying down

Causes

Main causes

• Often the exact cause is not known (idiopathic cardiomyopathy)
• Genetic mutations (inherited from a parent)
• High blood pressure that is not well controlled
• Heart valve problems
• Previous viral infections that damage the heart muscle
• Certain diseases such as diabetes, thyroid disorders, or haemochromatosis (too much iron in the body)
• Some chemotherapy drugs or other treatments

Risk factors

• Family history of cardiomyopathy or sudden cardiac death
• Uncontrolled high blood pressure
• Obesity
• Long-term heavy alcohol use
• Certain viral illnesses that affect the heart
• A history of preeclampsia during pregnancy

When to see a doctor

See a doctor urgently if:

• If you have chest pain, fainting, or severe shortness of breath, call your local emergency number immediately.

Book a routine appointment if:

• If you notice mild symptoms such as tiredness, swelling, or palpitations, see your doctor for an evaluation.

Diagnosis

Doctors use your medical history, a physical exam, and several tests to diagnose cardiomyopathy. They look for signs of heart enlargement or poor pumping function.

Tests that may be done

• Echocardiogram (an ultrasound of the heart)
• Electrocardiogram (ECG) to measure electrical activity
• Blood tests to check for other causes
• Chest X-ray to see the size of your heart
• Cardiac MRI for detailed images
• Stress test to see how your heart works during activity
• Genetic testing if a family cause is suspected

What to expect at your appointment

Your doctor will explain each test and what the results mean. Together, you will develop a treatment plan tailored to your needs.

Treatment

Treatment for cardiomyopathy aims to manage symptoms, improve heart function, and prevent complications. The plan depends on the type and severity of your condition.

Self-care at home

• Limit or avoid alcohol
• Stop smoking if you smoke
• Eat a heart-healthy diet low in salt and saturated fats
• Manage stress with relaxation techniques or counselling
• Get regular physical activity as advised by your doctor

Medical treatments

Medications may be prescribed to help the heart pump more effectively, reduce fluid buildup, control heart rate, or prevent blood clots. For some people, devices such as a pacemaker or an implantable cardioverter-defibrillator (ICD) are used to regulate the heartbeat or prevent sudden cardiac arrest. In severe cases, procedures like surgery to repair heart valves or a heart transplant may be considered. Always follow your doctor's advice.

When is surgery considered?

Surgery may be an option if medicines are not enough, for example to implant a heart device, repair a faulty valve, or perform a heart transplant in advanced disease.

Living with this condition

Living with cardiomyopathy means working with your healthcare team to manage your condition. Take your medicines as prescribed, keep regular appointments, and monitor for changes in your symptoms.

Lifestyle tips

• Avoid heavy alcohol use and smoking
• Maintain a healthy weight
• Get enough sleep and rest
• Keep a record of your symptoms to share with your doctor

Diet and exercise

A heart-healthy diet with less salt, less saturated fat, and plenty of fruits and vegetables is important. Exercise can help, but talk to your doctor first. Many people can do gentle activities like walking or swimming. Your doctor will tell you what is safe for you.

Mental health and emotional wellbeing

Living with a long-term heart condition can cause stress, anxiety, or sadness. It is common to feel worried. Talk to your doctor about counselling or support groups — you do not have to cope alone.

Prevention

Not all cases of cardiomyopathy can be prevented, especially those caused by genetics. However, a healthy lifestyle — such as not smoking, eating well, staying active, and managing blood pressure — can reduce your risk.

Vaccines

Get recommended vaccines, such as the flu shot and pneumonia vaccine, to avoid infections that could put extra strain on your heart.

Screening programmes

If you have a family history of cardiomyopathy, your doctor may recommend regular check-ups and tests to catch the condition early.

Complications

If left untreated

• Heart failure (when the heart cannot pump enough blood to meet the body's needs)
• Blood clots that can lead to stroke or other problems
• Arrhythmias (irregular heartbeats)
• Heart valve problems
• Sudden cardiac arrest (the heart stops beating suddenly)

Long-term outlook

With early diagnosis, proper treatment, and healthy lifestyle changes, many people with cardiomyopathy can manage their symptoms well and enjoy a good quality of life. Research continues to improve treatments and outcomes.

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