Cardiomyopathy Symptoms: Heart Muscle Disease, Testing and Next Steps

What it involves

MedlinePlus defines cardiomyopathy as diseases of the heart muscle. They enlarge the muscle or make it thicker and more rigid than normal, and in rare cases scar tissue replaces it. Some people live long, healthy lives with it, while in others the heart pumps blood less well. The main types are dilated, hypertrophic and restrictive cardiomyopathy, and arrhythmogenic right ventricular cardiomyopathy.

Who this is for

• Adults with shortness of breath, tiredness or swelling in the feet and ankles that is new.
• Patients with a family member who has a heart muscle disease or sudden heart problems.
• People with long-standing high blood pressure, diabetes, thyroid disease or past heart damage.
• Anyone told they have a heart murmur or an enlarged heart who wants to understand what it means.

What to expect

• Questions about breathing, swelling, chest discomfort, fainting, alcohol use and family heart history
• A physical exam that includes listening to the heart and lungs and checking the legs
• An EKG at the Loxahatchee and West Palm Beach offices when it is appropriate, plus blood work
• A referral for an echocardiogram or a heart specialist when the findings call for it

What goes wrong in the heart muscle

The MedlinePlus encyclopedia describes dilated cardiomyopathy as a condition in which the heart muscle becomes weakened and enlarged, so the heart cannot pump enough blood to the rest of the body. It is the most common form. Hypertrophic cardiomyopathy involves a thickened muscle, and restrictive cardiomyopathy involves a muscle that is stiff. The result in every type is a heart that is less able to move blood, which can lead to heart failure, abnormal rhythms and valve problems.

Causes and who is at risk

MedlinePlus says heart attacks, high blood pressure, infections and other diseases can all cause cardiomyopathy, and that some types run in families. For the dilated type, the encyclopedia names narrowed or blocked coronary arteries and poorly controlled blood pressure as the most common causes. Heavy long-term alcohol or drug use, diabetes, thyroid disease, some cancer medicines, fast heart rhythms and pregnancy-related changes can also play a part. In many people the cause is never found.

Symptoms to take seriously

The encyclopedia lists chest pain or pressure that is more likely with exercise, cough, fatigue, weakness, faintness, an irregular or rapid pulse, loss of appetite, shortness of breath with activity or after lying down, and swelling of the feet and ankles. These develop slowly in most people but can start suddenly. Other conditions look similar, so the shortness of breath guide and the leg swelling guide help sort out what else might be going on.

How it is diagnosed

A provider listens for an enlarged heart, murmurs and fluid in the lungs, and checks the neck veins and liver. MedlinePlus lists an echocardiogram, which is an ultrasound of the heart, as the key test, along with an electrocardiogram, stress tests, chest x-ray and sometimes heart MRI or catheterization. Blood tests look for causes such as thyroid disease or autoimmune conditions. The practice lists EKG and blood work, and the echocardiogram and other imaging are arranged by referral. A related page covers heart murmur evaluation.

Treatment and daily management

Treatment depends on the type and cause. MedlinePlus says it may involve medicines, surgery, other medical procedures and lifestyle changes. For a weakened heart, the encyclopedia describes taking prescribed medicines, watching weight, pulse and blood pressure, and limiting salt and fluids as your provider advises. Devices such as pacemakers and defibrillators are decided by heart specialists. Ongoing care for related conditions happens at routine visits, and the heart failure management page describes that side of care.

When to call 911

Heart muscle disease can cause serious complications, including abnormal heart rhythms and sudden cardiac arrest, according to MedlinePlus. Call 911 for chest pain or pressure that does not settle, fainting, a racing heartbeat with dizziness, or severe trouble breathing. Do not drive yourself. Milder changes, such as slowly increasing breathlessness or ankle swelling that returns each evening, deserve a prompt visit. The chest pain guide explains how to tell which situation you are in. A weakened heart that backs up fluid is the most common reason for fluid to collect around the lungs, and the pleural effusion guide explains the symptoms and how that fluid is checked. A narrowed aortic valve is a different heart problem that also causes breathlessness and chest tightness with activity, and the aortic stenosis guide explains how it is found with a heart ultrasound.

Sources

• MedlinePlus: Cardiomyopathy (health topic)
• MedlinePlus: Dilated cardiomyopathy (encyclopedia)