People who have cardiomyopathy but no signs or symptoms may not need treatment. Sometimes, dilated cardiomyopathy that comes on suddenly may even 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.
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 (SCA)
Treatments may include lifestyle changes, medicines, surgery, implanted devices to correct arrhythmias (irregular heartbeats), and/or a nonsurgical procedure.
Your doctor may suggest lifestyle changes to manage a condition that's causing your cardiomyopathy. These changes can help reduce symptoms.
Healthy Diet and Physical Activity
A healthy diet and physical activity are part of a healthy lifestyle. A healthy diet includes a variety of fruits, vegetables, and grains; half of your grains should come from whole-grain products.
Choose foods that are low in saturated fat, trans fat, and cholesterol. Healthy choices include lean meats, poultry without skin, fish, beans, and fat-free or low-fat milk and milk products.
Choose and prepare foods with little sodium (salt). Too much salt can raise your risk of high blood pressure. Recent studies show that following the Dietary Approaches to Stop Hypertension (DASH) eating plan can lower blood pressure.
Choose foods and beverages that are low in added sugar. If you drink alcoholic beverages, do so in moderation.
Aim for a healthy weight by staying within your daily calorie needs. Balance the calories you take in with the calories you use during physical activity. Be as physically active as you can.
Some people should get medical advice before starting or increasing physical activity. For example, talk with your doctor if you have a chronic (ongoing) health problem, are on medicine, or have symptoms such as chest pain, shortness of breath, or dizziness. Your doctor can suggest types and amounts of physical activity that are safe for you.
For more information about following a healthy diet, go to the National Heart, Lung, and Blood Institute's (NHLBI's) Aim for a Healthy Weight Web site, "Your Guide to a Healthy Heart," and "Your Guide to Lowering Your Blood Pressure With DASH." All of these resources provide general information about healthy eating.
Your doctor can help you decide what kind of eating plan and physical activity are right for you.
Other Lifestyle Changes
Your doctor also may recommend other lifestyle changes, such as:
- Quitting smoking
- Losing excess weight
- Avoiding the use of alcohol and illegal drugs
- Getting enough sleep and rest
- Reducing stress
- Treating underlying conditions, such as diabetes and high blood pressure
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 fluid and sodium from your body. Diuretics, or "water pills," are an example of a medicine that helps remove excess fluid and sodium from the body.
- 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.
Doctors use several types of surgery to treat cardiomyopathy. They include septal myectomy (mi-EK-toe-me), implanted devices to help the heart work better, and heart transplant.
Septal myectomy is open-heart surgery. It's used for people who have obstructive hypertrophic cardiomyopathy and severe symptoms. This surgery generally is used for younger patients and for people whose medicines aren't working well.
During the surgery, 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.
The surgeon also can repair or replace the mitral valve at the same time (if needed). Septal myectomy often is successful and allows you to return to a normal life with no symptoms.
Surgically Implanted Devices
Surgeons can place several types of devices in the heart to help it work better. One example is a pacemaker. This is a small device that's 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.
Sometimes doctors choose to use a cardiac resynchronization therapy (CRT) device. A CRT device coordinates contractions between the heart's left and right ventricles.
A left ventricular assist device (LVAD) 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.
An implantable cardioverter defibrillator (ICD) helps control life-threatening arrhythmias that may lead to SCA. 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 Health Topics Heart Transplant article.
Doctors may use a nonsurgical procedure called alcohol septal ablation to treat cardiomyopathy.
For this procedure, your 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.