Your doctor will conduct a physical examination, take a personal and family medical history, and ask when your symptoms occur — for example, whether exercise brings on your symptoms. If your doctor thinks you have cardiomyopathy, you might need to undergo several tests to confirm the diagnosis, including:
- Chest X-ray. An image of your heart will show whether it's enlarged.
- Echocardiogram. This uses sound waves to produce 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 impulses 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 provokes abnormal heart rhythms.
Cardiac catheterization. A thin tube (catheter) is inserted into your groin and threaded through your blood vessels to your heart. Doctors might extract a small sample (biopsy) of your heart for analysis in the laboratory. Pressure within the chambers of your heart can be measured to see how forcefully blood pumps through your heart.
Doctors might inject a dye into your blood vessels so that they show on X-rays (coronary angiogram). This test can be used to ensure there are no blockages in your blood vessels.
- Cardiac MRI. This test uses magnetic fields and radio waves to create images of your heart. Cardiac MRI might be used in addition to echocardiography, particularly 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 the heart size and function and 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 hereditary. Discuss genetic testing with your doctor. He or she might recommend family screening or genetic testing for your first-degree relatives — parents, siblings and children.
The goals of cardiomyopathy treatment are to manage your signs and symptoms, prevent your condition from worsening, and reduce your risk of complications. Treatment varies by which type of cardiomyopathy you have.
Your doctor might prescribe medications to improve your heart's pumping ability, improve blood flow, lower blood pressure, slow your heart rate, remove excess fluid from your body or keep blood clots from forming.
Be sure to discuss possible side effects with your doctor before taking any of these drugs.
Surgically implanted devices
Several types of devices can be placed 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 circulate through your heart. 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.
Other 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.
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.
Mayo Clinic Myectomy Expertise
Mayo Clinic heart surgeons have performed more than 3,000 myectomy procedures, with more than 250 performed each year on average. In the hands of expert centers, complication rates are very low and success rates very high. Recent data suggests that at low, medium and even "high" volume centers there is a gradient of mortality, meaning it's highest at the low volume centers and lowest at the high volume centers. But even those so-called high volume centers have mortality rates that are dramatically higher than is reported at the true expert centers. This is a procedure that should be done by those familiar with performing it at a high volume.
- Heart transplant. You might be a candidate for a heart transplant if medications and other treatments are no longer effective and you have end-stage heart failure.
Lifestyle and home remedies
These lifestyle changes can help you manage cardiomyopathy:
- Quit smoking.
- Lose weight if you're overweight.
- Eat a healthy diet, including a variety of fruits and vegetables and whole grains.
- Reduce the amount of salt in your diet, and aim for less than 1,500 milligrams of sodium daily.
- Get modest exercise after discussing with your doctor the most appropriate program of physical activity.
- Eliminate or minimize the amount of alcohol you drink. Specific recommendations will depend on the type of cardiomyopathy you have.
- 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 because of a family history, 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?