Treatments and drugs

By Mayo Clinic Staff

The overall goals of treatment for cardiomyopathy are to manage your signs and symptoms, prevent your condition from worsening, and reduce your risk of complications. Treatment varies by which major type of cardiomyopathy you have.

Dilated cardiomyopathy

If you're diagnosed with dilated cardiomyopathy, your doctor may recommend treatment including:

  • Medications. Your doctor may prescribe medications to improve your heart's pumping ability and function, improve blood flow, lower blood pressure, slow your heart rate, remove excess fluid from your body or keep blood clots from forming.
  • Surgically implanted devices. If you're at risk of serious heart rhythm problems, your doctor may recommend an implantable cardioverter-defibrillator (ICD) — a device that monitors your heart rhythm and delivers electric shocks when needed to control abnormal heart rhythms.

    In some cases, your doctor may recommend a pacemaker that coordinates the contractions between the right and left ventricles (biventricular pacemaker).

Hypertrophic cardiomyopathy

If you're diagnosed with hypertrophic cardiomyopathy, your doctor may recommend several treatments, including:

  • Medications. Your doctor may prescribe medications to relax your heart, slow its pumping action and stabilize its rhythm.
  • Implantable cardioverter-defibrillator (ICD). If you're at risk of serious heart rhythm problems, your doctor may recommend an ICD to monitor your heart rhythm and deliver electric shocks when needed to control abnormal heart rhythms.
  • Septal myectomy. In a septal myectomy, your 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 ablation. In 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.

Restrictive cardiomyopathy

Treatment for restrictive cardiomyopathy focuses on improving symptoms. Your doctor will recommend you pay careful attention to your salt and water intake and monitor your weight daily. Your doctor may also recommend you take diuretics if sodium and water retention becomes a problem. You may be prescribed medications to lower your blood pressure or control abnormal heart rhythms.

If the cause of your restrictive cardiomyopathy is found, treatment will also be directed at the underlying disease, such as amyloidosis.

Many of the medications that doctors prescribe for cardiomyopathy may have side effects. Be sure to discuss these possible side effects with your doctor before taking any of these drugs.

Arrhythmogenic right ventricular dysplasia

If you have arrhythmogenic right ventricular dysplasia, your doctor may recommend treatment including:

  • Implantable cardioverter-defibrillator (ICD). If you're at risk of dangerous heart rhythms, your doctor may recommend an ICD. An ICD monitors your heart rhythm and delivers electric shocks when needed to control abnormal heart rhythms.
  • Medications. If an ICD isn't appropriate to treat your condition, or if you have an ICD and have frequent fast heart rhythms, your doctor may prescribe medications to regulate your heart rhythm.
  • Radiofrequency ablation. If other treatments aren't controlling your abnormal heart rhythms, your doctor may recommend radiofrequency ablation.

    In this procedure, doctors guide long, flexible tubes (catheters) through your blood vessels to your heart. Electrodes at the catheter tips transmit energy to damage a small spot of abnormal heart tissue that is causing the abnormal heart rhythm.

Ventricular assist devices (VADs)

Ventricular assist devices (VADs) can help blood circulate through your heart. They usually are considered after less invasive approaches are unsuccessful. These devices can be used as a long-term treatment or as a short-term treatment while waiting for a heart transplant.

Heart transplant

You may be a candidate for a heart transplant if medications and other treatments are no longer effective, and you have end-stage heart failure.

March 17, 2015

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