Cardiomyopathy – Symptoms and Causes
Overview
Cardiomyopathy is a heart muscle disease that weakens the heart’s ability to pump blood throughout the body. This condition can trigger heart failure symptoms and may lead to other serious heart problems.
There are three main types: dilated, hypertrophic, and restrictive cardiomyopathy.
Treatment options vary based on the specific type and severity of the condition. Doctors typically prescribe medications as part of the treatment plan.
Some patients may need surgically implanted devices or heart surgery to manage their symptoms. For those with severe cases of cardiomyopathy, a heart transplant might become necessary.
Healthcare providers develop personalized treatment approaches depending on each patient’s particular form and stage of the disease.
Types
Cardiomyopathy comes in different forms. The two main types are:
- Dilated Cardiomyopathy: The heart chambers stretch and thin, reducing pumping ability.
- Hypertrophic Cardiomyopathy: Heart muscle walls thicken, making it harder for the heart to work properly.
These conditions affect the heart’s structure and function in different ways.
Signs of Heart Trouble
Cardiomyopathy affects people differently. Some never notice problems, while others develop symptoms as their heart condition worsens. These signs may include:
- Breathing difficulties during activity or even at rest
- Chest pain, particularly after exercising or eating large meals
- Irregular heartbeats that feel fast, pounding, or fluttery
- Swelling in the legs, ankles, feet, abdomen, and neck veins
- Abdominal bloating from fluid buildup
- Coughing when lying down
- Difficulty sleeping flat
- Tiredness even after resting
- Dizziness
- Fainting spells
Without treatment, these symptoms typically worsen over time. Some people deteriorate quickly, while others may remain stable for many years.
When Medical Help Is Needed
Contact your healthcare provider if you experience any cardiomyopathy symptoms. For severe symptoms like fainting, breathing problems, or chest pain lasting more than a few minutes, call 911 immediately.
Since some forms of cardiomyopathy run in families, your doctor might suggest screening for your relatives if you’re diagnosed with the condition. Early detection can lead to better management of the disease.
What Causes Cardiomyopathy
Cardiomyopathy develops from two main sources: acquired causes that happen during a person’s life and inherited factors passed down through families. Many cases have no clear cause, which doctors call idiopathic cardiomyopathy.
Acquired Causes
Several health conditions can damage heart muscle and lead to cardiomyopathy:
- High blood pressure that remains untreated for many years.
- Previous heart attacks that leave scarring on heart tissue.
- Consistent elevated heart rates that put a strain on the heart muscle.
- Heart valve problems causing abnormal blood flow.
- Viral infections, including COVID-19 and others, inflame heart tissue.
- Nutritional deficiencies, especially a lack of vitamin B-1 (thiamin).
- Pregnancy complications that put extra stress on the heart.
The heart can also be damaged by substances and treatments:
- Alcohol abuse over many years.
- Recreational drugs like cocaine and amphetamines.
- Anabolic steroids are used for muscle building.
- Some cancer treatments, including certain chemotherapy drugs and radiation.
Several metabolic and inflammatory conditions may affect the heart:
| Condition | How It Affects the Heart |
|---|---|
| Diabetes | Can damage small blood vessels and nerves |
| Thyroid disease | Disrupts normal heart rhythm and function |
| Hemochromatosis | Causes iron buildup in heart muscle |
| Sarcoidosis | Creates inflammatory granulomas in heart tissue |
| Amyloidosis | Deposits abnormal proteins in heart walls |
Inherited Causes
Some forms of cardiomyopathy run in families due to specific gene changes. Genetic testing can often identify these inherited forms.
Types of Cardiomyopathy
Different types affect the heart in unique ways:
Dilated Cardiomyopathy
This most common type makes heart chambers thin and stretch larger. It typically starts in the left ventricle (main pumping chamber). The enlarged heart struggles to pump blood effectively.
It affects people of all ages but appears most often in men under 50.
Hypertrophic Cardiomyopathy
The heart muscle thickens, making it harder for chambers to fill with blood. This often stems from genetic causes and can be more severe when it starts in childhood. Family history plays a strong role.
Restrictive Cardiomyopathy
Heart muscle becomes stiff and less flexible, preventing proper filling between beats. This rare type most commonly affects older adults. It can occur without an identifiable cause or result from conditions like amyloidosis.
Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)
In this rare form, heart muscle gets replaced by fatty tissue, particularly in the right ventricle. This can trigger dangerous heart rhythm problems. ARVC typically appears between ages 10 and 50 and often has genetic roots.
Other forms of cardiomyopathy exist that don’t fit these main categories.
Risk Factors
Several factors can increase your chances of developing cardiomyopathy:
Family Health History
- History of cardiomyopathy in relatives
- Family patterns of heart failure
- Sudden cardiac arrest in family members
Health Conditions
- Chronic high blood pressure
- Previous heart attack
- Coronary artery disease
- Heart infections
Lifestyle Factors
- Obesity
- Long-term heavy alcohol use
- Use of drugs like cocaine, amphetamines, and steroids
Medical Treatments
- Certain cancer chemotherapy drugs
- Radiation therapy
Other Medical Conditions
- Diabetes
- Thyroid disorders
- Hemochromatosis (iron overload)
- Amyloidosis (protein buildup in organs)
- Sarcoidosis (inflammatory tissue patches)
- Connective tissue problems
Complications
Cardiomyopathy can cause several dangerous health problems if not properly managed.
Heart failure occurs when the damaged heart cannot pump enough blood throughout the body. This condition requires immediate medical attention as it can be fatal without proper treatment.
Blood clots may develop inside the weakened heart chambers. These clots can break loose and travel to vital organs like the brain or lungs, blocking blood flow and causing serious damage.
Valve problems happen when the heart enlarges from cardiomyopathy. The valves may not close properly, allowing blood to leak backward instead of flowing forward as intended.
Dangerous heart rhythms can develop suddenly. These irregular heartbeats might cause:
- Fainting spells
- Cardiac arrest (when the heart stops beating effectively)
- Sudden death in severe cases
Prevention
Genetic forms of cardiomyopathy cannot be prevented. If family members have this heart condition, inform your healthcare provider.
You can reduce your risk of acquired cardiomyopathy by:
- Avoiding alcohol and recreational drugs, especially cocaine
- Managing existing health conditions like high blood pressure, cholesterol, and diabetes
- Following a nutritious diet
- Exercising regularly
- Getting adequate sleep
- Reducing stress levels
These healthy lifestyle choices can also help people with inherited cardiomyopathy manage their symptoms more effectively. Even when the condition cannot be prevented, these habits support overall heart health and may reduce complications.
