Diagnosis

Your doctor will perform a physical examination and ask questions about your personal and family medical history. You'll also be asked when your symptoms occur — for example, whether exercise brings on your symptoms. If your doctor thinks you have cardiomyopathy, several tests may be done to confirm the diagnosis, including:

  • Chest X-ray. An image of your heart will show whether it's enlarged.
  • Echocardiogram. This test uses sound waves to create images of the heart, which show its size and its motions as it beats. This test checks your heart valves and helps your doctor determine the cause of your symptoms.
  • Electrocardiogram (ECG). In this noninvasive test, electrode patches are attached to your skin to measure electrical signals from your heart. An ECG can show disturbances in the electrical activity of your heart, which can detect abnormal heart rhythms and areas of injury.
  • Treadmill stress test. Your heart rhythm, blood pressure and breathing are monitored while you walk on a treadmill. Your doctor might recommend this test to evaluate symptoms, determine your exercise capacity and determine if exercise triggers abnormal heart rhythms.
  • Cardiac catheterization. A thin tube (catheter) is inserted into your groin and threaded through your blood vessels to your heart. Pressure within the chambers of your heart can be measured to see how forcefully blood pumps through your heart. Dye can be injected through the catheter into your blood vessels to make them more visible on X-rays (coronary angiogram). A cardiac catheterization can reveal blockages in your blood vessels.

    During this test, doctors can remove a small tissue sample (biopsy) from your heart for analysis in the laboratory.

  • Cardiac MRI. This test uses magnetic fields and radio waves to create images of your heart. Your doctor might order a cardiac MRI if the images from your echocardiogram aren't helpful in making a diagnosis.
  • Cardiac CT scan. You lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest to assess heart size and function and the heart valves.
  • Blood tests. Several blood tests might be done, including those to check your kidney, thyroid and liver function and to measure your iron levels.

    One blood test can measure B-type natriuretic peptide (BNP), a protein produced in your heart. Your blood level of BNP might rise when your heart is in heart failure, a common complication of cardiomyopathy.

  • Genetic testing or screening. Cardiomyopathy can be passed down through families (inherited). Ask your doctor if genetic testing is right for you. He or she might recommend family screening or genetic testing for your first-degree relatives — parents, siblings and children.

Treatment

The goals of cardiomyopathy treatment are to:

  • Manage your signs and symptoms
  • Prevent your condition from worsening
  • Reduce your risk of complications

The type of treatment you receive depends on which type of cardiomyopathy you have.

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 abnormal heart rhythms, 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.

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 your heart rhythm and delivers electric shocks when needed to control abnormal heart rhythms. An ICD doesn't treat cardiomyopathy, but watches for and controls abnormal rhythms, a serious complication of the condition.
  • Ventricular assist device (VAD). This helps blood flow through your 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, 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 myectomy is used to treat hypertrophic cardiomyopathy.
  • Heart transplant. Your doctor might recommend a heart transplant if you have end-stage heart failure and medications and other treatments no longer work.

Lifestyle and home remedies

These lifestyle changes can help you manage cardiomyopathy:

  • Quit smoking.
  • Lose weight if you're overweight. Ask your doctor what a healthy weight is for you.
  • Get regular exercise, but talk to your doctor first about the safest type and amount for you.
  • Eat a healthy diet, including a variety of fruits and vegetables and whole grains.
  • Use less salt (sodium). Aim for less than 1,500 milligrams of sodium a day.
  • Avoid or drink less alcohol.
  • Try to manage your stress.
  • Get enough sleep.
  • Take all your medications as directed by your doctor.
  • Go to your doctor for regular follow-up appointments.

Preparing for your appointment

If you think you may have cardiomyopathy or are worried about your risk, make an appointment with your primary care doctor. He or she may refer you to a heart specialist (cardiologist).

Here's information to help you get ready for your appointment.

What you can do

Be aware of any pre-appointment restrictions. When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet.

Make a list of:

  • Your symptoms, including any that may seem unrelated to cardiomyopathy, and when they began
  • Key personal information, including a family history of cardiomyopathy, heart disease, stroke, high blood pressure or diabetes, and any major stresses or recent life changes
  • All medications, vitamins or other supplements you take, including doses
  • Questions to ask your doctor

Take a family member or friend along, if possible, to help you remember the information you're given.

For cardiomyopathy, some basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • What are other possible causes?
  • What tests do I need?
  • What treatment options are available, and which do you recommend for me?
  • How often should I be screened?
  • Should I tell my family members to be screened for cardiomyopathy?
  • I have other health conditions. How can I best manage these conditions together?
  • Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, including:

  • Do you have symptoms all the time, or do they come and go?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?