Cardiomyopathy

https://www.mayoclinic.org/diseases-conditions/hypertrophic-
cardiomyopathy/diagnosis-treatment/drc-20350204

This disease of the heart muscle can affect how your heart pumps blood to the rest of
your body. Learn more about the different types and their risk factors.
Cardiomyopathy (kahr-dee-o-my-OP-uh-thee) is a disease of the heart muscle that
makes it harder for your heart to pump blood to the rest of your body. Cardiomyopathy
can lead to heart failure.
The main types of cardiomyopathy include dilated, hypertrophic and restrictive
cardiomyopathy. Treatment — which might include medications, surgically implanted
devices, heart surgery or, in severe cases, a heart transplant — depends on which type
of cardiomyopathy you have and how serious it is.

Types

1. Dilated cardiomyopathy
2. Hypertrophic cardiomyopathy

Symptoms

There might be no signs or symptoms in the early stages of cardiomyopathy. But as the
condition advances, signs and symptoms usually appear, including:

 Breathlessness with activity or even at rest

 Swelling of the legs, ankles and feet
 Bloating of the abdomen due to fluid buildup
 Cough while lying down
 Difficulty lying flat to sleep
 Fatigue
 Heartbeats that feel rapid, pounding or fluttering
 Chest discomfort or pressure
 Dizziness, lightheadedness and fainting

Signs and symptoms tend to get worse unless treated. In some people, the condition
worsens quickly; in others, it might not worsen for a long time.
When to see a doctor

See your doctor if you have one or more signs or symptoms associated with
cardiomyopathy. Call 911 or your local emergency number if you have severe difficulty
breathing, fainting or chest pain that lasts for more than a few minutes.
Some types of cardiomyopathy can be passed down through families (inherited). If you
have the condition, your doctor might recommend that your family members be
checked.

Causes

Often the cause of the cardiomyopathy is unknown. In some people, however, it's the
result of another condition (acquired) or passed on from a parent (inherited).
Certain health conditions or behaviors that can lead to acquired cardiomyopathy
include:

 Long-term high blood pressure

 Heart tissue damage from a heart attack
 Long-term rapid heart rate
 Heart valve problems
 COVID-19 infection
 Certain infections, especially those that cause inflammation of the heart
 Metabolic disorders, such as obesity, thyroid disease or diabetes
 Lack of essential vitamins or minerals in your diet, such as thiamin (vitamin B-1)
 Pregnancy complications
 Iron buildup in your heart muscle (hemochromatosis)
 The growth of tiny lumps of inflammatory cells (granulomas) in any part of your body,
including your heart and lungs (sarcoidosis)
 The buildup of abnormal proteins in the organs (amyloidosis)
 Connective tissue disorders
 Drinking too much alcohol over many years
 Use of cocaine, amphetamines or anabolic steroids
 Use of some chemotherapy drugs and radiation to treat cancer
Dilated cardiomyopathy Open pop-up dialog box
 Hypert
rophic cardiomyopathy Open pop-up dialog box

Types of cardiomyopathy include:

 Dilated cardiomyopathy. In this type of cardiomyopathy, the pumping ability of

your heart's main pumping chamber — the left ventricle — becomes enlarged
(dilated) and can't effectively pump blood out of 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. The most common cause is coronary
artery disease or heart attack. However, it can also be caused by genetic defects.

Hypertrophic cardiomyopathy. This type involves abnormal thickening of your

heart muscle, which makes it harder for the heart to work. It mostly affects the
muscle of your heart's main pumping chamber (left ventricle).

Hypertrophic cardiomyopathy can develop at any age, but the condition tends to be
more severe if it occurs during childhood. Most people with this type of
 cardiomyopathy have a family history of the disease. Some genetic mutations have
been linked to hypertrophic cardiomyopathy.

Restrictive cardiomyopathy. In this type, the heart muscle becomes stiff and less
flexible, so it can't expand and fill with blood between heartbeats. This least
common type of cardiomyopathy can occur at any age, but it most often affects
older people.

Restrictive cardiomyopathy can occur for no known reason (idiopathic), or it can by

caused by a disease elsewhere in the body that affects the heart, such as
amyloidosis.

 Arrhythmogenic right ventricular dysplasia. In this rare type of cardiomyopathy, the

muscle in the lower right heart chamber (right ventricle) is replaced by scar tissue, which
can lead to heart rhythm problems. It's often caused by genetic mutations.

 Unclassified cardiomyopathy. Other types of cardiomyopathy fall into this category.

Risk factors

There are a number of things that can increase your risk of cardiomyopathy, including:

 Family history of cardiomyopathy, heart failure and sudden cardiac arrest

 Long-term high blood pressure
 Conditions that affect the heart, including a past heart attack, coronary artery disease or
an infection in the heart (ischemic cardiomyopathy)
 Obesity, which makes the heart work harder
 Long-term alcohol misuse
 Illicit drug use, such as cocaine, amphetamines and anabolic steroids
 Treatment with certain chemotherapy drugs and radiation for cancer

Many diseases also raise your risk of cardiomyopathy, including:

 Diabetes
 Thyroid disease
 Storage of excess iron in the body (hemochromatosis)
 Amyloidosis
 Sarcoidosis
 Connective tissue disorders
Complications

Enlarged heart, in heart failure

Cardiomyopathy can lead to serious complications, including:

 Heart failure. Your heart can't pump enough blood to meet your body's needs.
Untreated, heart failure can be life-threatening.
 Blood clots. Because your heart can't pump effectively, blood clots might form in your
heart. If clots enter your bloodstream, they can block the blood flow to other organs,
including your heart and brain.
 Heart valve problems. Because cardiomyopathy causes the heart to enlarge, the heart
valves might not close properly. This can cause blood to flow backward in the valve.
 Cardiac arrest and sudden death. Cardiomyopathy can trigger abnormal heart rhythms
that cause fainting or, in some cases, sudden death if your heart stops beating effectively.

Prevention

In many cases, you can't prevent cardiomyopathy. Let your doctor know if you have a
family history of the condition.
You can help reduce your risk of cardiomyopathy and other types of heart disease by
living a heart-healthy lifestyle and making lifestyle choices such as:

 Avoiding the use of alcohol or cocaine

 Controlling high blood pressure, high cholesterol and diabetes
 Eating a healthy diet
 Getting regular exercise
 Getting enough sleep
  Reducing your stress

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Cardiomyopathy is a medical term for a number of genetic and nongenetic diseases
involving the heart muscle that adversely affect the heart's mechanical pumping function
and its electrical system. It can occur in people of all ages, races or genders, and it is a
frequent cause of sudden cardiac arrest and sudden cardiac death. For [...]

Dilated cardiomyopathy
 Overview

Dilated
cardiomyopathyOpen pop-up dialog box

Dilated cardiomyopathy is a disease of the heart muscle that usually starts in your
heart's main pumping chamber (left ventricle). The ventricle stretches and thins (dilates)
and can't pump blood as well as a healthy heart can. Over time, both ventricles may be
affected. The term "cardiomyopathy" refers to diseases that affect the heart muscle
itself.
Dilated cardiomyopathy might not cause symptoms, but for some people it can be life-
threatening. It's a common cause of heart failure. Dilated cardiomyopathy can also lead
to irregular heartbeats (arrhythmias), blood clots or sudden death.
The condition can affect anyone, including infants and children.

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Symptoms

Signs and symptoms of dilated cardiomyopathy may include:

 Fatigue
 Shortness of breath (dyspnea) when you're active or lying down
 Reduced ability to exercise
 Swelling (edema) in your legs, ankles, feet and abdomen
 Chest pain or feelings of having a fast-beating, fluttering or pounding heart (palpitations)
  Extra or unusual sounds heard when your heart beats (heart murmurs), which your
doctor may find during a physical examination

Some people with dilated cardiomyopathy don't have any signs or symptoms in the
early stages of the disease.

When to see a doctor

If you are short of breath or have other symptoms of dilated cardiomyopathy, see your
doctor as soon as possible. Call 911 or your local emergency number if you have chest
pain that lasts more than a few minutes or have severe difficulty breathing.
If a family member has dilated cardiomyopathy, talk to your doctor. Early detection
using genetic testing may benefit people with inherited forms of dilated cardiomyopathy
who have no apparent signs or symptoms.

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Causes

It may be difficult to determine the cause of dilated cardiomyopathy. The condition often
runs in families (is inherited). However, many things can cause the left ventricle to dilate
and weaken, including:

 Diabetes
 Obesity
 Heart rhythm problems (arrhythmias)
 High blood pressure (hypertension)
 Complications of late-stage pregnancy
 Excessive iron in your heart and other organs (hemochromatosis)
 Certain infections

Other possible causes of dilated cardiomyopathy include:

 Alcohol abuse
 Use of certain cancer medications
 Use of illegal drugs, such as cocaine or amphetamines
 Exposure to toxins, such as lead, mercury and cobalt

Risk factors

Risk factors for dilated cardiomyopathy include:

 Long-term high blood pressure

 Family history of dilated cardiomyopathy, heart failure or sudden cardiac arrest
 Inflammation of the heart muscle from immune system disorders, such as lupus
 Damage to the heart muscle from certain diseases, such as hemochromatosis
 Neuromuscular disorders, such as muscular dystrophy
  Long-term excessive alcohol or illegal drug use

Complications

Complications from dilated cardiomyopathy include:

 Heart failure. If you have dilated cardiomyopathy, your heart might not be able to supply
your body with the blood it needs to work properly, leading to heart failure. Fluid can build
up in the lungs, abdomen, legs, ankles and feet.
 Heart valve regurgitation. Enlargement of the left ventricle may make it harder for your
heart valves to close, causing a backward flow of blood and making your heart pump less
effectively.
 Heart rhythm problems. Changes in your heart's structure and changes in pressure on
your heart's chambers can lead to the development of abnormal heart rhythms
(arrhythmias).
 Sudden cardiac arrest. Dilated cardiomyopathy can cause your heart to suddenly stop
beating.
 Blood clots (emboli). Pooling of blood in the left ventricle can lead to blood clots, which
may enter the bloodstream and cut off the blood supply to vital organs. These blood clots
can cause stroke, heart attack or damage to other organs. Arrhythmias can also cause
blood clots.

Prevention

Dilated cardiomyopathy often runs in families, and is not preventable. However, healthy
lifestyle habits can help you prevent or reduce complications of dilated cardiomyopathy.
If you have or are at risk for dilated cardiomyopathy:

 Don't smoke.
 Don't drink alcohol, or drink in moderation.
 Don't use cocaine or other illegal drugs.
 Eat a healthy diet that is low in salt (sodium).
 Maintain a healthy weight.
 Follow an exercise program recommended by your doctor.
 Get enough sleep and rest.
 Manage stress.
By Mayo Clinic Staff

Hypertrophic cardiomyopathy (HCM) 

Overview

Hypertrophic cardiomyopathyOpen pop-up dialog box

Hypertrophic cardiomyopathy (HCM) is a disease in which the heart muscle becomes

abnormally thick (hypertrophied). The thickened heart muscle can make it harder for the
heart to pump blood.
Hypertrophic cardiomyopathy often goes undiagnosed because many people with the
disease have few, if any, symptoms and can lead normal lives with no significant
problems. However, in a small number of people with HCM, the thickened heart muscle
can cause shortness of breath, chest pain or problems in the heart's electrical system,
resulting in life-threatening abnormal heart rhythms (arrhythmias) or sudden death.
Symptoms

Signs and symptoms of hypertrophic cardiomyopathy may include one or more of the
following:

 Chest pain, especially during exercise

 Fainting, especially during or just after exercise or exertion
 Heart murmur, which a doctor might detect while listening to your heart
 Sensation of rapid, fluttering or pounding heartbeats (palpitations)
 Shortness of breath, especially during exercise
When to see a doctor

A number of conditions can cause shortness of breath and heart palpitations. It's
important to get a prompt, accurate diagnosis and appropriate care. See your doctor if
you have a family history of HCM or any symptoms associated with hypertrophic
cardiomyopathy.
Call 911 or your local emergency number if you have any of the following symptoms for
more than a few minutes:

 Rapid or irregular heartbeat

 Difficulty breathing
 Chest pain
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Causes

Hypertrophic cardiomyopathy is usually caused by abnormal genes (gene mutations)

that cause the heart muscle to grow abnormally thick.
In most people with hypertrophic cardiomyopathy, the muscular wall (septum) between
the two bottom chambers of the heart (ventricles) becomes thicker than normal. As a
result, the thicker wall may block blood flow out of the heart. This is called obstructive
hypertrophic cardiomyopathy.
If there's no significant blocking of blood flow, the condition is called nonobstructive
hypertrophic cardiomyopathy. However, the heart's main pumping chamber (left
ventricle) may become stiff. This makes it hard for the heart to relax and reduces the
amount of blood the ventricle can hold and send to the body with each heartbeat.
People with hypertrophic cardiomyopathy also have an abnormal arrangement of heart
muscle cells (myofiber disarray). This can trigger arrhythmias in some people.

Risk factors

Hypertrophic cardiomyopathy is usually passed down through families (inherited).

If you have a parent with hypertrophic cardiomyopathy, you have a 50% chance of
having the genetic mutation for the disease.
Parents, children or siblings of a person with hypertrophic cardiomyopathy should ask
their doctors about screening for the disease.

Complications

Many people with hypertrophic cardiomyopathy (HCM) don't have significant health
problems. But complications of hypertrophic cardiomyopathy can include:

 Atrial fibrillation. Thickened heart muscle, as well as the abnormal structure of heart

cells, can cause changes in the heart's electrical system, resulting in fast or irregular
heartbeats. Atrial fibrillation can also increase your risk of developing blood clots, which
can travel to your brain and cause a stroke.
 Blocked blood flow. In many people, the thickened heart muscle blocks the blood flow
leaving the heart, causing shortness of breath with exertion, chest pain, dizziness and
fainting spells.
 Mitral valve problems. If the thickened heart muscle blocks the blood flow leaving the
heart, the valve between the left atrium and left ventricle (mitral valve) may not close
properly. As a result, blood can leak backward into the left atrium (mitral valve
regurgitation), possibly leading to worsening symptoms.
 Dilated cardiomyopathy. In a very small number of people with HCM, the thickened
heart muscle may become weak and ineffective. The ventricle becomes enlarged (dilated),
and its pumping ability becomes less forceful.
 Heart failure. The thickened heart muscle can eventually become too stiff to effectively
fill the heart with blood. As a result, your heart can't pump enough blood to meet your
body's needs.
 Sudden cardiac death. Rarely, hypertrophic cardiomyopathy can cause heart-related
sudden death in people of all ages. Because many people with hypertrophic
cardiomyopathy don't realize they have it, sudden cardiac death may be the first sign of a
problem. It can happen in seemingly healthy young people, including high school athletes
and other young, active adults.

Prevention

There is no known prevention for hypertrophic cardiomyopathy. But it's important to

identify the condition as early as possible to guide treatment and prevent complications.
If you have a first-degree relative — a parent, sibling or child — with hypertrophic
cardiomyopathy, doctors may recommend genetic testing to screen for the condition.
However, not everyone with HCM has a currently detectable mutation. Also, some
insurance companies may not cover genetic testing.
If genetic testing isn't done, or if the results aren't helpful, then your doctor may
recommend echocardiograms on a regular basis if you have a family member with
hypertrophic cardiomyopathy. Adolescents and competitive athletes should be screened
once a year. Adults who don't compete in athletics should be screened every five years.

By Mayo Clinic Staff