Cardiomyopathy (kahr-dee-oh-my-OP-uh-thee) is a disease that weakens and enlarges your heart muscle. There are three main types of cardiomyopathy — dilated, hypertrophic and restrictive — all of which affect your heart muscle. Cardiomyopathy makes it harder for your heart to pump blood and deliver it to the rest of your body. There are many causes of cardiomyopathy, including coronary artery disease and valvular heart disease. Cardiomyopathy can lead to heart failure. Cardiomyopathy can be treated. The type of treatment you'll receive depends on which type of cardiomyopathy you have and how serious it is. Your treatment may include medications, surgically implanted devices or, in severe cases, a heart transplant.

Alternative Names of Cardiomyopathy are: Cardiomyopathy – peripartum.

Complications of Cardiomyopathy

• Cardiac arrhythmias (can be deadly)
• Congestive heart failure
• Pulmonary emboli (blood clots in the lungs)

Causes of Cardiomyopathy

Most of the time, the cause of the cardiomyopathy is unknown. In some people, however, doctors are able to identify some contributing factors. Possible causes of cardiomyopathy include:

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

The three types of cardiomyopathy are:

• Dilated cardiomyopathy. This is the most common type of cardiomyopathy. In this disorder, your heart's main pumping chamber — the left ventricle — becomes enlarged (dilated), its pumping ability becomes less forceful, and blood doesn't flow as easily through the heart. Although this type can affect people of all ages, it occurs most often in middle-aged people and is more likely to affect men. Some people with dilated cardiomyopathy have a family history of the condition.
• Hypertrophic cardiomyopathy. This type involves abnormal growth or thickening of your heart muscle, particularly affecting the muscle of your heart's main pumping chamber. As thickening occurs, the heart tends to stiffen and the size of the pumping chamber may shrink, interfering with your heart's ability to deliver blood to your body. Hypertrophic cardiomyopathy can develop at any age, but the condition tends to be more severe if it becomes apparent during childhood. Most affected people have a family history of the disease, and some genetic mutations have been linked to hypertrophic cardiomyopathy.
• Restrictive cardiomyopathy. The heart muscle in people with restrictive cardiomyopathy becomes rigid and less elastic, meaning the heart can't properly expand and fill with blood between heartbeats. While restrictive cardiomyopathy can occur at any age, it most often tends to affect older people. It's the least common type of cardiomyopathy and can occur for no known reason (idiopathic). The condition may also be caused by diseases elsewhere in the body that affect the heart.

Signs & Symptoms of Cardiomyopathy

Some people who develop cardiomyopathy have no signs and symptoms during the early stages of the disease. But as the condition advances, signs and symptoms usually appear. Cardiomyopathy symptoms may include:

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

No matter what type of cardiomyopathy you have, signs and symptoms tend to get worse unless treated. In certain people, this worsening happens quickly, while in others, cardiomyopathy may not worsen for a long time.

Diagnosis of Cardiomyopathy

Your doctor will conduct a physical examination, take a personal and family medical history, and ask when your symptoms occur — for example, whether exercise brings on your symptoms. If your doctor thinks you have cardiomyopathy, you may need to undergo several tests to confirm the diagnosis. These tests may include:

• Chest X-ray. An image of your heart will show whether it's enlarged.
• Echocardiogram. An echocardiogram uses sound waves to produce images of the heart. Your doctor can use these images to examine the size of your heart and its motions as it beats.
• Electrocardiogram (ECG). In this noninvasive test, electrode patches are attached to your skin to measure electrical impulses from your heart. An ECG can show disturbances in the electrical activity of your heart, which can detect abnormal heart rhythms and areas of injury.
• Cardiac catheterization and biopsy. In this procedure, a thin tube (catheter) is inserted in your groin and threaded through your blood vessels to your heart, where a small sample (biopsy) of your heart can be extracted for analysis in the laboratory. Pressure within the chambers of your heart can be measured to see how forcefully blood pumps through your heart. Pictures of the arteries of the heart can be taken during the procedure (coronary angiogram) to ensure that you do not have any blockage.
• Cardiac magnetic resonance imaging (MRI). Cardiac MRI is an imaging technique that uses magnetic fields and radio waves to create images of your heart. Cardiac MRI is often used in addition to echocardiography, particularly if the images from your echocardiogram aren't helpful in making a diagnosis.
• Blood tests. One blood test can measure B-type natriuretic peptide (BNP), a protein produced in your heart. Your blood level of BNP rises when your heart is subjected to the stress of heart failure, a common complication of cardiomyopathy.

A variety of other blood tests may be done, including those to check your kidney function and look for anemia and thyroid problems. Your iron level may be measured. Having too much may indicate an iron overload disorder called hemochromatosis. Accumulating too much iron in your heart muscle can weaken it and cause cardiomyopathy.

Treatments of Cardiomyopathy

The woman may need to stay in the hospital until acute symptoms subside.

Because the heart dysfunction is usually reversible, and the women are usually young, everything possible will be done to ensure survival.

This may include taking extreme measures such as:

• Use of a balloon heart pump (aortic counterpulsation balloon)
• Immunosuppressive therapy (such as medicines used to treat cancer or prevent rejection of a transplanted organ)
• Heart transplant

For most women, however, treatment focuses simply on relieving the symptoms. Some symptoms resolve on their own without treatment.

Medications include:

• Digitalis to strengthen the heart's pumping ability
• Diuretics (water pills) to remove excess fluid
• Low-dose beta-blockers

A low-salt diet may be recommended. Fluid may be restricted in some cases. Activities, including nursing the baby, may be limited when symptoms develop.

Daily weighing may be recommended. A weight gain of 3 or 4 pounds or more over 1 or 2 days may be a sign of fluid buildup.

Women who smoke and drink alcohol will be advised to stop, since these habits may make the symptoms worse.

Prevention of Cardiomyopathy

Eat a well-balanced, nutritious diet, exercise to increase cardiovascular fitness, and avoid cigarettes and alcohol. Your doctor may advise you to avoid getting pregnant again if you have had heart failure during a previous pregnancy.

When to seek Medical Advice

See your doctor if you have one or more of the signs and symptoms associated with cardiomyopathy. Call your local emergency number if you experience severe difficulty breathing, fainting or chest pain that lasts for more than a few minutes. Because the condition is sometimes hereditary, your doctor may advise that your family members be examined for cardiomyopathy.