Cardiomyopathy

The diagnosis of cardiomyopathy is often clear from an individual's descriptions of his or her symptoms, the results of a physical examination, and the results of a chest x-ray, echocardiogram, and electrocardiogram.

Occasionally, a test called an endomyocardial biopsy is necessary. In this test, a catheter is inserted into a vein in the neck and passed down into the heart. A small piece of the inner heart wall is removed using a tiny metal device at the tip of the catheter. The sample of heart tissue is then examined under the microscope.Shortness of breath or trouble breathing, especially with physical exertion.

Fatigue.

Swelling in the ankles, feet, legs, abdomen and veins in the neck.

Dizziness.

Lightheadedness.

Fainting during physical activity.

Arrhythmias (abnormal heartbeats)

The goals of cardiomyopathy treatment are to:

Manage signs and symptoms

Prevent the condition from worsening

Reduce the risk of complications

The type of treatment depends on the type of cardiomyopathy and its severity.

Medications

Many different types of medications are used to treat cardiomyopathy. Medications for cardiomyopathy can help:

Improve the heart's ability to pump blood

Improve blood flow

Lower blood pressure

Slow heart rate

Remove extra fluid from the body

Prevent blood clots

Therapies

Nonsurgical procedures used to treat cardiomyopathy or arrhythmia include:

Septal ablation. A small portion of the thickened heart muscle is destroyed by injecting alcohol through a long, thin tube (catheter) into the artery supplying blood to that area. This allows blood to flow through the area.

Radiofrequency ablation. To treat irregular heart rhythms, health care providers guide long, flexible tubes (catheters) through blood vessels to the heart. Electrodes at the catheter tips transmit energy to damage a small spot of heart tissue that is causing the irregular heart rhythm.

Surgery or other procedures

Several types of devices can be surgically implanted in the heart to improve its function and relieve symptoms, including:

Implantable cardioverter-defibrillator (ICD). This device monitors heart rhythm and delivers electric shocks when needed to control irregular heart rhythms. An ICD doesn't treat cardiomyopathy; rather it watches for and controls irregular rhythms, a serious complication of the condition.

Ventricular assist device (VAD). This helps blood flow through the heart. A VAD usually is considered after less invasive approaches are unsuccessful. It can be used as a long-term treatment or as a short-term treatment while waiting for a heart transplant.

Pacemaker. This small device placed under the skin in the chest or abdomen uses electrical impulses to control arrhythmias.

Types of surgery used to treat cardiomyopathy include:

Septal myectomy. In this open-heart surgery, a surgeon removes part of the thickened heart muscle wall (septum) that separates the two bottom heart chambers (ventricles). Removing part of the heart muscle improves blood flow through the heart and reduces mitral valve regurgitation. Septal myectomy is used to treat hypertrophic cardiomyopathy.

Heart transplant. A heart transplant might be for people with end-stage heart failure for whom medications and other treatments no longer work.