Types of Cardiomyopathy and Treatment Options

Cardiomyopathy is a disease that affects the heart muscle (known as the myocardium). There are different types of cardiomyopathy. Each of these causes damage to the heart muscle, such as enlarging it or making it stiffer than normal.

With cardiomyopathy, your heart is not able to keep a regular electrical rhythm and cannot effectively pump blood. The condition weakens your heart and can lead to heart failure. However, medication, surgery, and lifestyle changes can help improve your prognosis.

Types of Cardiomyopathy

The cardiomyopathy disorders cause changes that weaken or alter the function of the heart muscle. However, the exact changes that occur vary by disease type. The type of disease you have also affects your treatment and outlook.

Common types of cardiomyopathy include:

• Dilated cardiomyopathy: Stretches the heart muscle
• Hypertrophic cardiomyopathy: Thickens the heart muscle
• Restrictive cardiomyopathy: Stiffens the heart muscle
• Arrhythmogenic right ventricular cardiomyopathy: Replaces heart muscle tissue with fatty tissue
• Transthyretin amyloid cardiomyopathy (ATTR-CM): Causes a buildup of a protein that stiffens the heart muscle
• Peripartum cardiomyopathy: Enlarges the heart muscle chambers during late pregnancy or postpartum
• Broken heart syndrome (Takotsubo cardiomyopathy): Stress-induced cardiomyopathy that develops from intense emotional or physical stress, resulting in changes in rhythm and blood substances but with no evidence of blockage
• Unclassified cardiomyopathy: Heart disorder whose cause is unknown but may be related to an underlying condition
  

Family history, age, race, and other unique factors can affect the type of disease you get.

Symptoms

Cardiomyopathy impacts people differently. Some may never have signs of sickness. Others may have symptoms that grow worse as the disease causes more damage.

Signs of illness can be the same across different types of this disease. Common symptoms include:

• Shortness of breath, especially after physical exertion
• Dizziness
• Fainting
• Chest pain
• Fatigue
• Swelling of the arms and legs
• Heart palpitations
  

As cardiomyopathy progresses, you may develop additional signs of heart failure, including a persistent cough that becomes worse when you lie down, swelling of the abdomen, weight gain, and confusion or impaired cognition.

Causes

This disease can be described as primary or secondary. Primary cardiomyopathy involves causes that only affect the heart muscle. Secondary cardiomyopathy results from a condition that also affects other parts of your body.

Primary cardiomyopathy can be caused by genetic disorders. Hypertrophic cardiomyopathy, for instance, is related to an inherited mutation. Primary cardiomyopathy can also be due to disorders acquired during life, such as peripartum cardiomyopathy during pregnancy.

Common causes of secondary cardiomyopathy include:

• Autoimmune diseases such as rheumatoid arthritis
• Infections such as hepatitis C
• Endocrine diseases such as diabetes
• Neuromuscular disorders such as muscular dystrophy
• Nutritional deficits such as a niacin deficiency

You can also develop cardiomyopathy without a known cause.

Risk Factors

Cardiomyopathy impacts all genders and people of all ages, including children. However, some people are more likely to develop heart disease.

Factors that can increase your risk of cardiomyopathy include:

• Family history of heart disease
• Pre-existing disorders that lead to secondary cardiomyopathy
• Diseases that cause heart damage, such as hemochromatosis (where the body stores too much iron) or cardiac sarcoidosis (a disease that leads to clusters of blood cells called granulomas)
• Chemotherapy or radiation treatments for cancer
• Excessive alcohol use
• Uncontrolled high blood pressure
  

Diagnosing Cardiomyopathy

A cardiomyopathy diagnosis typically occurs after you report symptoms to your healthcare provider. Your symptoms and family history help define the types of tests you need.

Some common tests used to diagnose this disease include:

• Blood test
• Chest X-ray
• Echocardiogram (ECG)
• Electrocardiogram (EKG)
• Treadmill stress test
• Cardiac magnetic resonance imaging (MRI)
• Cardiac computerized tomography (CT) scan
  

If you have an inherited form of cardiomyopathy, genetic tests might help you assess your risk of transmitting this disease to your children. Genetic testing can also help detect inherited forms of cardiomyopathy before they produce signs of sickness.

Treatment

Treatment goals for people with cardiomyopathy include slowing disease progression, managing symptoms, and avoiding potential complications. Potential treatments vary considerably depending on which type of cardiomyopathy you have, and the severity of your condition.

Treating Primary Cardiomyopathy

Treatment for primary cardiomyopathy typically involves starting and keeping a healthy way of life. This includes the following steps:

• Eating a heart-healthy diet
• Boosting physical activity
• Reducing stress
• Limiting or avoiding alcohol
• Quitting smoking

Medicine may be prescribed to control signs of illness. The most common types of medicines used include:

• ACE inhibitors, angiotensin II receptor blockers (ARBs), beta blockers, and calcium channel blockers to lower blood pressure
• Beta blockers, calcium channel blockers, and Digox (digoxin) to slow an irregular heart rate
• Antiarrhythmics to prevent irregular heartbeats
• Aldosterone blockers to balance electrolytes
• Diuretics to remove excess fluid
• Anticoagulants, or blood thinners, to prevent blood clots
• Corticosteroids to reduce inflammation
  

Some patients with cardiomyopathy benefit from a pacemaker. This surgically implanted device monitors your heart's rhythm. When your heart beats too slow or too fast, a pacemaker delivers an electrical signal to restore a regular beat.

Based on your disease, you may need heart surgery to correct the damage. Treatment for the most advanced stages of this illness may require a heart transplant.

Treating Secondary Cardiomyopathy

If you have secondary cardiomyopathy, treatment for your heart-related symptoms involves the same therapies used for primary cardiomyopathy. Secondary cardiomyopathy may be treated with lifestyle changes, medication, an implanted medical device, and/or heart surgery.

However, treating secondary cardiomyopathy also involves addressing the underlying condition that caused your heart disease. This is necessary to prevent further heart damage.

Treatment for secondary cardiomyopathy varies widely depending on the underlying condition. For example, in cases of alcoholic cardiomyopathy, treatment may include the cessation of all alcohol consumption.

Prognosis

There is no cure for cardiomyopathy. However, a supervised treatment plan can help slow down the disease. The right treatment can also improve your quality of life.

Without treatment, cardiomyopathy can lead to heart failure. This is a serious condition that can be life-threatening.

In the end stages of cardiomyopathy, heart rhythm disorders and blood clots are common, which can raise the risk of stroke or sudden heart attack.

Coping With Cardiomyopathy

Living with cardiomyopathy means dealing with both physical and emotional changes. Feeling afraid or depressed about your illness is normal. It's common to feel lonely or angry if your sickness limits your lifestyle.

Doing your best to take care of your physical health (e.g., following a healthy diet, exercising, getting enough sleep) can also aid your mental and emotional health. Living a healthy lifestyle can help you maintain a sense of normalcy and routine, which makes the coping process easier.

Realize that your feelings can affect your physical state. Getting support from others in online and in-person support groups and/or sharing your concerns with family and friends can help ease the emotional burden.

Don't be afraid to discuss your feelings with your healthcare provider. They may advise you to get professional help from a mental health professional.

Summary

Cardiomyopathy involves a group of progressive conditions that damage your heart muscle. Symptoms include shortness of breath, fatigue, and an irregular heartbeat.

Knowing your disease risk can help you identify the condition early and get treatment when it can be most effective. Treatment varies based on the cause and symptoms of your condition. It involves lifestyle changes, medicine, and/or surgery. A surgically implanted device, surgery, and in extreme cases, a heart transplant, may also be necessary. The goal is to slow the disease and improve signs of sickness.

A Word From Verywell

You can do a few things to improve your chances of living a normal life with cardiomyopathy. Get an annual medical examination and report any symptoms to your medical provider. An early diagnosis and proper treatment can help prevent heart damage before the disease worsens.

Even if you don't have symptoms, you should know your risk of having this condition. Discuss genetic testing with your healthcare provider if you have a close family member who has this disease.

Living with cardiomyopathy involves managing both the physical and emotional aspects of this condition. Seek support from your healthcare provider, family and friends, and others who can help.