Cardiomyopathy

What is cardiomyopathy?

Cardiomyopathy is the name for several heart conditions which affect your heart muscle. The walls of your heart chambers might become thick, stiff, or stretched.  This prevents your heart from being able to pump blood around the body as well as it should. 

Some people live with cardiomyopathy without any problems — but others need treatment to prevent serious illness.

What types of cardiomyopathy are there?

There are several types of cardiomyopathy, like:

• dilated cardiomyopathy — your heart’s muscle walls stretch and weaken, making it harder for your heart to contract as strongly. This is the most common type.
• hypertrophic cardiomyopathy — your heart muscle cells get bigger and thicker, making it hard for your heart to fill with blood properly
• arrhythmogenic right ventricular cardiomyopathy — when your heart muscle cells die and get replaced with scar tissue
• restrictive cardiomyopathy — your heart chambers become stiff or scarred and can’t relax properly, making it hard for your heart to fill with blood. This is the least common type.
• postpartum cardiomyopathy — dilated cardiomyopathy, but it develops at the end of your pregnancy or after you give birth
• Stress-induced or takotsubo cardiomyopathy — when your heart becomes temporarily bigger after stress

Cardiomyopathy symptoms

Cardiomyopathy symptoms vary from person to person — some people don’t experience symptoms at all. But they might include:

• an irregular heartbeat
• feeling dizzy or faint
• feeling out of breath
• feeling tired
• a swollen tummy, face, legs, or feet (oedema)
• chest pain or a heavy chest
• coughing up mucus or blood
• finding exercise more difficult

Certain types of cardiomyopathy might cause heart failure or arrhythmia. But this only happens if your condition’s serious.

What causes cardiomyopathy?

Most cardiomyopathies have no clear cause. Some types of cardiomyopathy can be inherited from your parents. It affects children and adults.

It’s also caused by things that cause inflammation in your heart (myocarditis), like:

• drinking alcohol long term
• taking certain medicines — like cancer drugs
• using recreational stimulants long term — like amphetamines and cocaine
• some viruses
• inflammatory conditions — like rheumatoid arthritis

Some health conditions can also cause cardiomyopathy, like obesity, high blood pressure (hypertension), coronary artery disease, and haemochromatosis. Hormone disorders, like thyroid conditions and diabetes, can also cause it.

How is cardiomyopathy diagnosed?

If you have symptoms of cardiomyopathy, it’s important to speak to a GP. They might send you to a heart specialist, who'll check your heart for symptoms of this condition using:

• an electrocardiogram (ECG) — an electrical recording of your heart’s rhythm
• an echocardiogram (echo) — an ultrasound scan of your heart
• a heart rhythm monitor — an ECG, but used for 24 or 48 hours
• an MRI scan — using magnetic and radio waves to make detailed images of your heart

They can recommend treatment depending on what they find.

Can cardiomyopathy be treated?

People with mild cardiomyopathy often don’t need treatment. Instead, lifestyle changes can help your symptoms, like eating a healthy diet (like the Mediterranean diet) and stopping smoking.

If your symptoms are serious, treatment depends on what type of cardiomyopathy you have. You might need to take new medicines, like:

• beta-blockers  — to help your heartbeat stay regular
• medication for high blood pressure
• anticoagulants — to prevent blood clots

You might also have a surgical procedure, like:

• having a pacemaker fitted  — a device that helps your heart beat at a healthy rhythm
• having an implantable cardioverter-defibrillator  (ICD) fitted — a device that monitors your heartbeat and stops it from beating at a dangerous rhythm
• an arrhythmia ablation — treatment that changes the tissue causing your heart problems 
• a septal myectomy — surgery to remove your heart’s thickened muscular wall

Can cardiomyopathy be prevented?

Maintaining a healthy lifestyle can reduce your cardiomyopathy risk. 

If you have a genetic cardiomyopathy, it can’t be prevented — but you can still benefit from a healthy lifestyle because it’ll help control symptoms. You can do things like:

• regular exercise — aim for 150 minutes of moderate activity or 75 minutes of vigorous activity a week
• eating a diet full of fruit, vegetables, oily fish, nuts and seeds, and whole grains — like a Mediterranean diet 
• maintaining a healthy weight
• not drinking more than 14 units of alcohol a week
• stopping smoking — after a few weeks of no smoking, your inflammation levels become lower 
• eating less than 6 grams of salt a day
• avoiding recreational drugs