Cardiomyopathy refers to a variety of diseases of the heart muscle that affect the heart’s ability to carry out its pumping function. It is a progressive condition that can lead to other heart health issues including heart failure, but it can be managed through a combination of medications, lifestyle changes, surgical procedures, and other types of treatment. Here’s what to know about causes, symptoms, and treatment options for the main types of cardiomyopathy.

Causes and symptoms of cardiomyopathy

Cardiomyopathy can be either acquired or inherited. While not all cases of cardiomyopathy have known causes, the following health factors or conditions have been linked to certain forms of cardiomyopathy.

• A family health history of cardiomyopathy, heart failure, or sudden cardiac arrest

• Coronary artery disease or a history of a heart attack

• Endocrine diseases including type 1 and type 2 diabetes and thyroid disorders

• Infections of the heart muscle

• Diseases that weaken muscle tissue such as muscular dystrophy 

• Long-term use of alcohol and/or cocaine

• Long-term high blood pressure

Cardiomyopathy symptoms vary by individual, and by the specific type of cardiomyopathy. The following signs often become more apparent as the condition progresses.

• Difficulty breathing or shortness of breath, even while at rest

• Fatigue

• Swelling in the feet, ankles, and legs

• An irregular heartbeat, heart murmur, or heart palpitations

• Chest pain or pressure

• Dizziness, lightheadedness, fainting, or briefly passing out

Main types of cardiomyopathy

Dilated cardiomyopathy

The most common type of cardiomyopathy and a leading cause for heart transplants, dilated cardiomyopathy occurs when the left ventricle — one of the heart’s main pumping chambers — becomes enlarged and cannot pump blood to other organs as effectively as a healthy heart. It can affect individuals of all ages but is most common during middle age. Men are more likely than women to develop dilated cardiomyopathy. Coronary artery disease and heart attacks are common causes, but the condition may also stem from genetics. Those with dilated cardiomyopathy may face a greater risk for heart failure in the long term.

Hypertrophic cardiomyopathy

One of the most common forms of genetic heart disease, hypertrophic cardiomyopathy is an inherited condition characterized by thickening of the heart muscle, often in the left ventricle. It affects individuals of all ages but often develops during childhood or early adulthood. There is a strong genetic component to this condition, and most affected individuals have a family history of hypertrophic cardiomyopathy. If you have a family history of hypertrophic cardiomyopathy, you may want to consult with your physician about genetic testing options. Some individuals with hypertrophic cardiomyopathy develop an arrhythmia, which is an irregular heartbeat.

Restrictive cardiomyopathy

The least common of the three main types of cardiomyopathy, restrictive cardiomyopathy occurs when the heart muscle stiffens and cannot fill with enough blood between heartbeats. It is most common in older age groups and often occurs as the result of another heart-related health condition such as amyloidosis, hemochromatosis, scleroderma, or sarcoidosis. Restrictive cardiomyopathy itself is not believed to be inherited, but many of the related conditions mentioned above have a genetic component.

Arrhythmogenic right ventricular dysplasia

Arrhythmogenic right ventricular dysplasia occurs when muscle in the right ventricle is replaced by fat or scar tissue, potentially leading to heart rhythm issues. It is a rare form of cardiomyopathy that often develops as the result of a genetic mutation and most commonly affects teens and young adults.

Treating cardiomyopathy

Cardiomyopathy treatment varies by individual. Your doctor may recommend a combination of medications, medical devices, or surgical procedures to control your cardiomyopathy symptoms and slow the progression of the condition.

Medications may be used to improve blood flow and the heart’s pumping function, lower blood pressure, slow your heart rate, and/or prevent blood clots. The following types of medications are commonly used in the treatment of cardiomyopathy.

• Blood pressure medications such as ACE inhibitors, angiotensin II receptor blockers (ARBs), and diuretics

• Heart rate controlling medications such as beta blockers, calcium channel blockers, and digoxin (Digox®, Lanoxin®, and Digitek®)

• Blood thinners and antiplatelet medications such as warfarin (Coumadin®) and novel oral anticoagulants (NOACs)

• Antiarrhythmic medications such as amiodarone (Pacerone®) and dronedarone (Multaq®)

If you are experiencing an arrhythmia as the result of cardiomyopathy, your doctor may recommend a device such as a pacemaker or an implantable cardioverter defibrillator (ICD) to help control your heartbeat. Other devices including a cardiac resynchronization therapy (CRT) device and a left ventricular assist device (LVAD) may be used to improve the heart’s pumping function and control blood flow.

Some individuals with cardiomyopathy need a non-surgical procedure to treat their condition or a related arrhythmia. Common procedures include a septal ablation, in which a portion of the thickened heart muscle is destroyed to allow for more blood flow, and a radiofrequency ablation, which targets a portion of abnormal heart tissue to address an abnormal heart rhythm. In more severe cases, open-heart surgery or a heart transplant may be required.

Maintaining a heart-healthy lifestyle is another aspect of managing cardiomyopathy, as lifestyle choices can affect the progression of the condition and the severity of symptoms. If you have cardiomyopathy, your doctor may recommend that you quit smoking (if applicable), limit your alcohol intake, plan a heart-healthy diet, and exercise more frequently. While inherited forms of cardiomyopathy cannot be prevented, these healthy habits can lower your risk for related health complications and help you experience an active life.

Take charge of your heart health

At Alto, we make it as simple as possible to manage your risk for heart health issues and follow the treatment plan your doctor recommends. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Reach out any time via phone at 1-800-874-5881 or in-app messaging.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

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