Cardiomyopathy — Types, Symptoms and Treatment in Hyderabad
Cardiomyopathy is a disease of the heart muscle itself — distinct from coronary artery disease, valve disease, or hypertensive heart disease, although these conditions can eventually cause cardiomyopathy. The heart muscle becomes structurally abnormal — either weakened and dilated, thickened and obstructed, or stiffened and non-compliant — impairing the heart's ability to pump effectively.
Types of cardiomyopathy
| Dilated cardiomyopathy (DCM) | The left ventricle dilates and weakens — the most common type. Causes include genetic mutations (30–40% familial), prior viral myocarditis, alcohol excess, tachycardia-induced (from uncontrolled AF), peripartum (during or after pregnancy), and chemotherapy toxicity. Many cases are idiopathic. |
| Hypertrophic cardiomyopathy (HCM) | Abnormal thickening of the heart muscle — most commonly the interventricular septum — often with outflow tract obstruction. The most common inherited cardiac condition — affecting 1 in 500 adults. A leading cause of sudden cardiac death in young athletes. Can be asymptomatic for decades. |
| Restrictive cardiomyopathy | The heart muscle becomes stiff and non-compliant — impairing filling rather than contraction. Causes include amyloidosis (protein deposition), sarcoidosis, haemochromatosis, and radiation damage. Cardiac amyloidosis (ATTR and AL types) is increasingly recognised and now has specific treatments. |
| Arrhythmogenic cardiomyopathy (ARVC) | Fatty or fibrous replacement of right ventricular muscle — a genetic condition causing ventricular arrhythmias and sudden death, particularly in young athletes. Often first presents with palpitations or syncope during exercise. |
| Takotsubo (stress) cardiomyopathy | Acute reversible left ventricular dysfunction triggered by severe emotional or physical stress — mimicking a heart attack. The left ventricle takes on an apical ballooning shape. Usually recovers fully within weeks with supportive management. |
Symptoms
- Breathlessness on exertion — Gradually worsening shortness of breath as cardiac function declines.
- Fatigue and reduced exercise capacity — Early and common symptom due to reduced cardiac output.
- Swollen ankles and legs — Fluid retention caused by worsening heart failure.
- Palpitations and irregular heartbeat — Arrhythmias are common across different cardiomyopathy subtypes.
- Chest pain — May occur, particularly in hypertrophic cardiomyopathy (HCM) with obstruction or reduced blood supply to the heart muscle.
- Syncope (blackouts) — Can occur in HCM, arrhythmogenic right ventricular cardiomyopathy (ARVC), or due to serious arrhythmias, and may indicate increased risk of sudden cardiac death.
- Sudden cardiac death — In some young individuals with HCM or ARVC, this may be the first manifestation of disease.