What is the definition of Cardiomyopathy?

Cardiomyopathy is disease of abnormal heart muscle in which the heart muscle becomes weakened, stretched, or has another structural problem. It often contributes to the heart's inability to pump or function well.

Many people with cardiomyopathy have heart failure.

What are the causes for Cardiomyopathy?

There are many types of cardiomyopathy, with different causes. Some of the more common ones are:

• Dilated cardiomyopathy (also called idiopathic dilated cardiomyopathy) is a condition in which the heart becomes weak and the chambers get large. As a result, the heart cannot pump enough blood out to the body. It can be caused by many medical problems.
• Hypertrophic cardiomyopathy (HCM) is a condition in which the heart muscle becomes thick. This makes it harder for blood to leave the heart. This type of cardiomyopathy is most often passed down through families.

• Ischemic cardiomyopathy is caused by a narrowing of the arteries that supply the heart with blood. It makes the heart walls thin so they do not pump well.
• Restrictive cardiomyopathy is a group of disorders. The heart chambers are unable to fill with blood because the heart muscle is stiff. The most common causes of this type of cardiomyopathy are amyloidosis and scarring of the heart from an unknown cause.
• Peripartum cardiomyopathy occurs during pregnancy or in the first 5 months afterward.

What are the current treatments for Cardiomyopathy?

When possible, the cause of cardiomyopathy is treated. Medicines and lifestyle changes are often needed to treat the symptoms of heart failure, angina and abnormal heart rhythms.

Procedures or surgeries may also be used, including:

• A defibrillator that sends an electrical pulse to stop life-threatening abnormal heart rhythms
• A pacemaker that treats a slow heart rate or helps the heart beat in a more coordinated fashion
• Coronary artery bypass (CABG) surgery or angioplasty that may improve blood flow to the damaged or weakened heart muscle
• Heart transplant that may be tried when all other treatments have failed

Partially and fully implantable mechanical heart pumps have been developed. These may be used for very severe cases. However, not all people need this advanced treatment.

What is the outlook (prognosis) for Cardiomyopathy?

The outlook depends on many different things, including:

• Cause and type of cardiomyopathy
• The severity of the heart problem
• How well the condition responds to treatment

Heart failure is most often a long-term (chronic) illness. It may get worse over time. Some people develop severe heart failure. In this case, medicines, surgery, and other treatments may no longer help.

People with certain types of cardiomyopathy are at risk for dangerous heart rhythm problems.

REFERENCES

Falk RH and Hershberger RE. The dilated, restrictive, and infiltrative cardiomyopathies. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 77.

McKenna WJ, Elliott PM. Diseases of the myocardium and endocardium. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 54.

McMurray JJV, Pfeffer MA. Heart failure: management and prognosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 53.

Rogers JG, O'Connor. CM. Heart failure: pathophysiology and diagnosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 52.