How Is Cardiomyopathy Diagnosed?

Your doctor will diagnose cardiomyopathy based on your medical history, a physical exam, and the results from tests and procedures.

Specialists Involved

Often, a cardiologist or pediatric cardiologist diagnoses and treats cardiomyopathy. A cardiologist is a doctor who specializes in treating heart diseases. A pediatric cardiologist is a doctor who specializes in treating heart diseases in children.

Medical History

Your doctor will want to learn about your medical history. He or she will want to know what symptoms you have and how long you've had them. Your doctor also will want to know whether anyone in your family has had cardiomyopathy, heart failure, or sudden cardiac arrest.

Physical Exam

Your doctor will use a stethoscope to listen to your heart and lungs for sounds that may suggest cardiomyopathy. These sounds may even suggest a certain type of the disease.

For example, the loudness, timing, and location of a heart murmur may suggest hypertrophic obstructive cardiomyopathy. A "crackling" sound in the lungs may be a sign of heart failure. (This condition often develops in the later stages of cardiomyopathy.)

Physical signs also help your doctor diagnose cardiomyopathy. Swelling of the ankles, feet, legs, or abdomen suggests fluid buildup, a sign of heart failure.

Signs or symptoms of cardiomyopathy may be found during a routine exam. For example, your doctor may hear a heart murmur or you may have abnormal test results.

Diagnostic Tests

You may have one or more of the following tests to diagnose cardiomyopathy.

Blood Tests

During a blood test, a small amount of blood is taken from your body. It's usually drawn from a vein in your arm using a thin needle. The procedure usually is quick and easy, although it may cause some short-term discomfort.

Blood tests give your doctor information about your heart and help rule out other conditions.

Chest X Ray

A chest x ray takes pictures of the organs and structures inside your chest, including your heart, lungs, and blood vessels. This test can show whether your heart is enlarged. A chest x ray also can show whether fluid is building up in your lungs.

EKG (Electrocardiogram)

An EKG is a simple test that records the heart's electrical activity. This test shows how fast your heart is beating and whether the rhythm of your heartbeat is steady or irregular. An EKG also records the strength and timing of electrical signals as they pass through each part of your heart.

This test is used to detect and study many heart problems, such as heart attack, arrhythmia, and heart failure. EKG results also can suggest other disorders that affect heart function.

Echocardiography

Echocardiography (EK-o-kar-de-OG-ra-fee) is a test that uses sound waves to create a moving picture of your heart. The picture shows how well your heart is working and its size and shape.

There are several different types of echocardiography, including a stress echocardiogram, or "stress echo." This test is done as part of a stress test. A stress echo can show whether you have decreased blood flow to your heart, a sign of coronary artery disease.

Another type of echo is a transesophageal (tranz-ih-sof-uh-JEE-ul) echo, or TEE. TEE provides a view of the back of the heart.

For a TEE, a sound wave wand is put on the end of a special tube. The tube is gently passed down your throat and into your esophagus (the passage leading from your mouth to your stomach). You will be given medicine to relax you during this procedure.

Stress Test

Some heart problems are easier to diagnose when your heart is working hard and beating fast. During stress testing, you exercise (or are given medicine) to make your heart work hard and beat fast while heart tests are done.

These tests may include nuclear heart scanning, echocardiography, magnetic resonance imaging (MRI), and positron emission tomography (PET) scanning of the heart.

Diagnostic Procedures

You may have one or more medical procedures to confirm a diagnosis or if surgery is planned. These procedures may include cardiac catheterization (KATH-e-ter-i-ZA-shun), coronary angiography (an-jee-OG-ra-fee), or myocardial (mi-o-KAR-de-al) biopsy.

Cardiac Catheterization

This procedure checks the pressure and blood flow in your heart's chambers. The procedure also allows your doctor to collect blood samples and look at your heart's arteries using x-ray imaging.

During cardiac catheterization, a long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck and threaded to your heart. This allows your doctor to study the inside of your arteries to look for blockages.

Coronary Angiography

This procedure often is done with cardiac catheterization. During the procedure, dye that can be seen on an x ray is injected into your coronary arteries. The dye lets your doctor study the flow of blood through your heart and blood vessels.

Dye also may be injected into your heart chambers. This allows your doctor to study the pumping function of your heart.

Myocardial Biopsy

For this procedure, your doctor removes a piece of your heart muscle. This can be done during cardiac catheterization. The heart muscle is studied under a microscope to see whether changes in cells have occurred that may suggest cardiomyopathy.

The biopsy is useful for diagnosing some types of cardiomyopathy.

Genetic Testing

Some types of cardiomyopathy run in families. Thus, your doctor may suggest genetic testing to look for the disease in your parents, brothers and sisters, or other family members.

Genetic testing can show how the disease runs in families. It also can find out the chances of parents passing the genes for the disease on to their children.

Genetic testing also may be useful if your doctor thinks you may have cardiomyopathy, but you don't yet have signs or symptoms. Your doctor can then start treatment early, when it may be more effective.