People who have cardiomyopathy but no signs or symptoms may not need treatment. Sometimes, dilated cardiomyopathy that comes on suddenly may go away on its own. For other people who have cardiomyopathy, treatment is needed. Treatment depends on the type of cardiomyopathy you have, the severity of your symptoms and complications, and your age and overall health. Treatments may include:
The main goals of treating cardiomyopathy include:
- Managing any conditions that cause or contribute to the disease
- Controlling signs and symptoms so that you can live as normally as possible
- Stopping the disease from getting worse
- Reducing complications and the risk of sudden cardiac arrest
Your doctor may suggest lifestyle changes to manage a condition that’s causing your cardiomyopathy including:
- Heart-healthy eating
- Physical activity
- Quitting smoking
- Maintaining a healthy weight
- Managing stress
Your doctor may recommend heart-healthy eating, which should include:
- Whole grains
- Fruits, such as apples, bananas, oranges, pears, and prunes
- Vegetables, such as broccoli, cabbage, and carrots
- Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans
- Fat-free or low-fat dairy products, such as fat-free milk
- Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week
When following a heart-healthy diet, you should avoid eating:
- A lot of red meat
- Palm and coconut oils
- Sugary foods and beverages
Two nutrients in your diet make blood cholesterol levels rise:
- Saturated fat—found mostly in foods that come from animals
- Trans fat (trans fatty acids)—found in foods made with hydrogenated oils and fats such as stick margarine; baked goods such as, cookies, cakes, and pies, crackers, frostings, and coffee creamers. Some trans fats also occur naturally in animal fats and meats.
Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples:
|If you eat:||Try to eat no more than:|
|1,200 calories a day||8 grams of saturated fat a day|
|1,500 calories a day||10 grams of saturated fat a day|
|1,800 calories a day||12 grams of saturated fat a day|
|2,000 calories a day||13 grams of saturated fat a day|
|2,500 calories a day||17 grams of saturated fat a day|
Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels.
Some sources of monounsaturated and polyunsaturated fats are:
- Olive, canola, peanut, safflower, and sesame oils
- Peanut butter
- Nuts and seeds, such as walnuts
- Corn, sunflower, and soybean oils
- Salmon and trout
Try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and “no added salt” foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more.
Dietary Approaches to Stop Hypertension
Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt.
The DASH eating plan is a good heart-healthy eating plan, even for those who don’t have high blood pressure. Read more about DASH.
Talk to your doctor about how much alcohol you drink. Too much alcohol will raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain. Your doctor may recommend that you reduce the amount of alcohol you drink or stop drinking alcohol.
Routine physical activity can lower many risk factors for coronary heart disease, including LDL (“bad”) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. HDL is the “good” cholesterol that helps prevent coronary heart disease.
Everyone should try to participate in moderate intensity aerobic exercise at least 2 hours and 30 minutes per week, or vigorous intensity aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats harder and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week.
Read more about physical activity at:
- U.S. Department of Health and Human Services’ 2008 Physical Activity Guidelines for Americans
- What Is Physical Activity? Health Topic
Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you.
If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.
If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.
Read more about quitting smoking at Smoking and Your Heart.
Maintaining a Healthy Weight
Maintaining a healthy weight can lower your risk for coronary heart disease. Body mass index (BMI) measures your weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institute’s (NHLBI) online BMI calculator or talk to your doctor. A BMI:
- Below 18.5 is a sign that you are underweight.
- Between 18.5 and 24.9 is in the normal range.
- Between 25 and 29.9 is considered overweight.
- Of 30 or more is considered obese.
A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal.
Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk. For more information about losing weight or maintaining your weight, go to Aim for a Healthy Weight.
Research shows that the most commonly reported “trigger” for a heart attack is an emotionally upsetting event—particularly one involving anger. Also, some of the ways people cope with stress—such as drinking, smoking, or overeating—aren’t healthy.
Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Having supportive people in your life with whom you can share your feelings or concerns can help relieve stress.
Physical activity, medicine, and relaxation therapy also can help relieve stress. You may want to consider taking part in a stress management program.
Many medicines are used to treat cardiomyopathy. Your doctor may prescribe medicines to:
- Lower your blood pressure. ACE inhibitors, angiotensin II receptor blockers, beta blockers, and calcium channel blockers are examples of medicines that lower blood pressure.
- Slow your heart rate. Beta blockers, calcium channel blockers, and digoxin are examples of medicines that slow the heart rate. Beta blockers and calcium channel blockers also are used to lower blood pressure.
- Keep your heart beating with a normal rhythm. These medicines, called antiarrhythmics, help prevent arrhythmias.
- Balance electrolytes in your body. Electrolytes are minerals that help maintain fluid levels and acid-base balance in the body. They also help muscle and nerve tissues work properly. Abnormal electrolyte levels may be a sign of dehydration (lack of fluid in your body), heart failure, high blood pressure, or other disorders. Aldosterone blockers are an example of a medicine used to balance electrolytes.
- Remove excess sodium from your body. Diuretics, or water pills, are an example of medicines that help remove excess sodium from the body, which reduces the amount of fluid in your blood.
- Prevent blood clots from forming. Anticoagulants, or blood thinners, are an example of a medicine that prevents blood clots. Blood thinners often are used to prevent blood clots from forming in people who have dilated cardiomyopathy.
- Reduce inflammation. Corticosteroids are an example of a medicine used to reduce inflammation.
Septal myectomy is open-heart surgery and is used to treat people who have hypertrophic cardiomyopathy and severe symptoms. This surgery generally is used for younger patients and for people whose medicines aren’t working well.
A surgeon removes part of the thickened septum that’s bulging into the left ventricle. This improves blood flow through the heart and out to the body. The removed tissue doesn’t grow back. If needed, the surgeon also can repair or replace the mitral valve at the same time. Septal myectomy often is successful and allows you to return to a normal life with no symptoms.
Surgeons can place several types of devices in the heart to improve function and symptoms, including:
- Pacemaker. This small device is placed under the skin of your chest or abdomen to help control arrhythmias. The device uses electrical pulses to prompt the heart to beat at a normal rate.
- Cardiac resynchronization therapy (CRT) device. A CRT device coordinates contractions between the heart’s left and right ventricles.
- Left ventricular assist device (LVAD). This device helps the heart pump blood to the body. An LVAD can be used as a long-term therapy or as a short-term treatment for people who are waiting for a heart transplant.
- Implantable cardioverter defibrillator (ICD). An ICD helps control life-threatening arrhythmias that may lead to sudden cardiac arrest. This small device is implanted in the chest or abdomen and connected to the heart with wires. If an ICD senses a dangerous change in heart rhythm, it will send an electric shock to the heart to restore a normal heartbeat.
For this surgery, a surgeon replaces a person’s diseased heart with a healthy heart from a deceased donor. A heart transplant is a last resort treatment for people who have end-stage heart failure. “End-stage” means the condition has become so severe that all treatments, other than heart transplant, have failed. For more information about this treatment, go to the Heart Transplant Health Topic.
Doctors may use a nonsurgical procedure called alcohol septal ablation to treat cardiomyopathy. During this procedure, the doctor injects ethanol (a type of alcohol) through a tube into the small artery that supplies blood to the thickened area of heart muscle. The alcohol kills cells, and the thickened tissue shrinks to a more normal size. This procedure allows blood to flow freely through the ventricle, which improves symptoms.