Cardiomyopathy, sometimes referred to as heart muscle disease or enlarged heart, is a disease of the heart muscle. In most cases, it causes your heart muscle to enlarge or become thick or rigid.

These changes make it difficult for your heart to pump blood throughout the body. In rare cases, cardiomyopathy causes diseased heart muscle tissue to be replaced with scar tissue.

Cardiomyopathy has several types, including:

• Arrhythmogenic right ventricular dysplasia
• Dilated cardiomyopathy
• Hypertrophic cardiomyopathy
• Hypertrophic obstructive cardiomyopathy
• Ischemic cardiomyopathy
• Restrictive cardiomyopathy
• Transthyretin amyloid cardiomyopathy

Often, the exact cause of cardiomyopathy is unknown. We know that the disease can be caused by your genes (inherited through your parents) or other medical conditions that you develop (acquired). Acquired cardiomyopathy can develop from:

In addition to family history and existing medical conditions, there are lifestyle factors that can raise your risk of cardiomyopathy, such as:

Your physician will do a physical exam. They will also ask questions about your medical history, family medical history and recent symptoms. A cardiologist specializes in heart conditions and will diagnose and treat cardiomyopathy.

Your physician may order one or multiple tests to confirm cardiomyopathy and any conditions related to the disease, such as:

• Ambulatory monitors (Holter monitor), which record your heart’s activity over a period of time
• Blood tests to check your electrolyte levels or look for genetic issues
• Electrocardiogram (ECG or EKG) to detect your heart’s electrical activity and measure the time and duration of its activity.
• Heart or myocardial biopsy, which involves taking and analyzing a small piece of tissue from the heart muscle.
• Stress tests, which are medically supervised exercise tests, check if physical exertion triggers or worsens cardiomyopathy.

You may also get imaging tests, such as: 

• Cardiac catheterization, a procedure in which physicians place a tube (catheter) in your coronary arteries. This helps them understand how your heart is working.
• Chest X-ray may be used to take pictures of the inside of your chest. It shows if your heart is enlarged.
• Coronary angiography, a procedure in which dye is injected into your coronary arteries. The dye can be seen on an x-ray, allowing your healthcare professional to study blood flow among your heart and blood vessels.
• Echocardiogram, which uses sound waves to create pictures of your heart’s size, structure and motion.

For most people, the goal of treatment is to slow the progression of cardiomyopathy and control its symptoms. If a physician has diagnosed you with the disease, but you don’t have symptoms, you may decide together that treatment isn’t needed.

If necessary, your physician may change your diet, activity level, and other aspects of your lifestyle. This treatment is often combined with medications, medical devices, and surgery. We are the only medical center in Sacramento, Calif. performing alcohol septal ablation.

Your treatment plan will depend on your type of cardiomyopathy, how severe it is, and whether you have any additional medical complications. 

Medications 

Cardiomyopathy often restricts the flow of blood. Your physician may prescribe medicine that will:  

• Remove excess sodium and fluids from your body
• Relax your blood vessels (blood pressure) and make it easier for your heart to pump blood
• Slow your heart rate if you have an irregular heartbeat
• Balance your electrolyte levels
• Thin the blood to help prevent clots

Lifestyle Changes 

Adopting heart-healthy lifestyle changes is the most common way to prevent and treat cardiomyopathy. These lifestyle changes include: 

• Controlling cholesterol levels
• Eating a heart-healthy diet
• Exercising regularly
• Limiting or avoiding alcohol consumption
• Losing excess weight
• Managing chronic conditions like diabetes or sleep apnea
• Quitting smoking or other tobacco use

View our heart health classes

Nonsurgical Therapies 

Your physician may recommend nonsurgical procedures to treat cardiomyopathy, including: 

• Alcohol septal ablation: A physician injects ethanol (alcohol) into the artery that supplies blood to the affected area of the heart muscle thickened by cardiomyopathy. A small part of the muscle dies, shrinking the tissue to its normal size.
• Radiofrequency or catheter ablation: This procedure is not a direct treatment for cardiomyopathy. Rather, it stops certain irregular heartbeats, a common symptom of cardiomyopathy. Physicians pass tubes (catheters) through blood vessels to the heart. A machine will send energy through the tubes to create a small scar on the heart tissue. Those scars prevent abnormal electrical signals from causing irregular heartbeats.

Surgery 

If medications, therapies and lifestyle changes are not effective, your physician may recommend one of several surgeries to treat cardiomyopathy.

Devices to correct an irregular heartbeat include: 

• Pacemaker: A small device that uses electrical pulses to prompt the heart to beat normally.  
• Implantable cardioverter defibrillator (ICD): A device that maintains a heart’s normal rhythm by sending a shock to the heart if it detects an irregular heartbeat.

Devices that can help improve blood flow include: 

• Cardiac resynchronization therapy (CRT) device: A physician implants the CRT device into the lower chambers of your heart (ventricles). The device helps your ventricles contract together rather than at different times.
• Left ventricular assist device (LVAD): LVAD is a mechanical pump that helps the heart pump blood to the body.

Other surgical procedures include: 

• Septal myectomy: This surgery improves blood flow. It is often reserved for younger people or people for whom medications are ineffective. In this procedure, the surgeon removes the part of the heart’s thickened wall (septum) bulging into heart’s left ventricle. 
• Heart transplant: A physician replaces a person’s diseased heart with a healthy donor heart. A heart transplant is often a treatment of last resort. Most transplant recipients are in end-stage heart failure.