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Cardiomyopathy

Cardiomyopathy is disease in which the heart muscle becomes weakened, stretched, or has another structural problem. It often occurs when the heart cannot pump or function well.

 

Most people with cardiomyopathy have heart failure.

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Causes

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.

Treatment

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 or are able to have this advanced treatment.

Outlook (Prognosis)

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 Saunders; 2018:chap 77.

McKenna WJ, Elliott P. Diseases of the myocardium and endocardium. In Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 60.

McMurray JJV, Pfeffer MA. Heart failure: management and prognosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 59.

O'Connor CM, Rogers JG. Heart failure: pathophysiology and diagnosis. In Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 58.

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  • Cardiomyopathy overview

    Animation

  •  

    Cardiomyopathy overview - Animation

    Types, causes, symptoms, health risks, and treatment of cardiomyopathy.

  • Heart, section through the middle - illustration

    The interior of the heart is composed of valves, chambers, and associated vessels.

    Heart, section through the middle

    illustration

  • Heart, front view - illustration

    The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.

    Heart, front view

    illustration

  • Dilated cardiomyopathy - illustration

    Dilated cardiomyopathy involves enlargement of the heart muscle and is the most common type of cardiomyopathy. The heart muscle is weakened and cannot pump blood efficiently. Decreased heart function affects the lungs, liver, and other body systems.

    Dilated cardiomyopathy

    illustration

  • Hypertrophic cardiomyopathy - illustration

    Hypertrophic cardiomyopathy is the thickening of the muscles that make up the heart. The thickening may interfere with the normal functioning of the heart by narrowing the outflow of the ventricle; reducing the ability of the heart to relax and fill with blood during the relaxation phase; or reducing the ability of the valves of the heart to function properly. Any situation that increases the contraction or rate of contraction of the heart muscle can worsen these symptoms.

    Hypertrophic cardiomyopathy

    illustration

  • Peripartum cardiomyopathy - illustration

    Peripartum cardiomyopathy is a rare disorder in which a weakened heart is diagnosed within the last month of pregnancy or within 5 months after delivery, without other identifiable causes for dysfunction of the heart. The heart muscle becomes enlarged and weakened and cannot pump blood efficiently. Decreased heart function affects the lungs, liver, and other body systems.

    Peripartum cardiomyopathy

    illustration

  • Cardiomyopathy overview

    Animation

  •  

    Cardiomyopathy overview - Animation

    Types, causes, symptoms, health risks, and treatment of cardiomyopathy.

  • Heart, section through the middle - illustration

    The interior of the heart is composed of valves, chambers, and associated vessels.

    Heart, section through the middle

    illustration

  • Heart, front view - illustration

    The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.

    Heart, front view

    illustration

  • Dilated cardiomyopathy - illustration

    Dilated cardiomyopathy involves enlargement of the heart muscle and is the most common type of cardiomyopathy. The heart muscle is weakened and cannot pump blood efficiently. Decreased heart function affects the lungs, liver, and other body systems.

    Dilated cardiomyopathy

    illustration

  • Hypertrophic cardiomyopathy - illustration

    Hypertrophic cardiomyopathy is the thickening of the muscles that make up the heart. The thickening may interfere with the normal functioning of the heart by narrowing the outflow of the ventricle; reducing the ability of the heart to relax and fill with blood during the relaxation phase; or reducing the ability of the valves of the heart to function properly. Any situation that increases the contraction or rate of contraction of the heart muscle can worsen these symptoms.

    Hypertrophic cardiomyopathy

    illustration

  • Peripartum cardiomyopathy - illustration

    Peripartum cardiomyopathy is a rare disorder in which a weakened heart is diagnosed within the last month of pregnancy or within 5 months after delivery, without other identifiable causes for dysfunction of the heart. The heart muscle becomes enlarged and weakened and cannot pump blood efficiently. Decreased heart function affects the lungs, liver, and other body systems.

    Peripartum cardiomyopathy

    illustration

 

Review Date: 5/16/2018

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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