Conditions

Cardiomyopathy

An artistic representation of the heart under strain

Understanding Cardiomyopathy: A Story of the Heart’s Silent Struggle

At first, Mr. Lim thought it was just age catching up. The breathlessness climbing stairs. The tightness in his chest after walking the dog. But when even tying his shoes became exhausting, he knew something was wrong.

What Is Cardiomyopathy?

Cardiomyopathy is not a single disease, but a family of conditions that affect the heart muscle (myocardium). It makes the heart stiff, enlarged, or thickened—preventing it from pumping blood efficiently. Over time, this can lead to heart failure, arrhythmias, blood clots, and in severe cases, sudden cardiac death.

Though it may sound rare, cardiomyopathy affects people of all ages—including young athletes and pregnant mothers—and can be inherited or acquired later in life.

Types of Cardiomyopathy

Just like each patient is unique, so is their heart condition. There are several main types of cardiomyopathy, each with its own story:

Dilated Cardiomyopathy (DCM)

• The most common form, where the heart chambers stretch and become weak. It often leads to heart failure.

Hypertrophic Cardiomyopathy (HCM)

• An inherited condition where the heart muscle becomes abnormally thick. It’s a leading cause of sudden cardiac death in young athletes, especially when undiagnosed.

Restrictive Cardiomyopathy

• A rarer type, where the heart becomes stiff and can’t fill properly—often linked to other diseases like amyloidosis.

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)

• A genetic disorder where healthy heart muscle is replaced with scar tissue, disrupting normal rhythms.

Takotsubo Cardiomyopathy (Stress Cardiomyopathy)

• Often triggered by emotional or physical stress, mimicking a heart attack—also known as “broken heart syndrome.”

Peripartum Cardiomyopathy

• Occurs during the last month of pregnancy or within five months postpartum.

Unclassified Cardiomyopathies

• Some cases don’t fit neatly into these types and require specialized evaluation.

Symptoms: What to Watch For

Cardiomyopathy may creep in silently, but as it progresses, it often speaks through:

• Shortness of breath—even at rest
• Fatigue and weakness
• Swelling in the legs, ankles, or abdomen
• Irregular heartbeats or palpitations
• Chest pain
• Fainting spells or dizziness

These symptoms can overlap with other conditions, which is why a thorough heart evaluation is critical.

What Causes Cardiomyopathy?

Some people are born with it. Others develop it over time. Risk factors include:

• Family history of cardiomyopathy or sudden death
• Previous heart attacks or coronary artery disease
• High blood pressure
• Valvular heart disease
• Viral infections
• Autoimmune or metabolic disorders
• Lifestyle habits (e.g., alcohol abuse, drug use)

Diagnosing Cardiomyopathy

Diagnosing cardiomyopathy requires a multi-layered approach—something I emphasize in my clinic. Key tools include:

• Echocardiogram: To assess heart structure and function
• Electrocardiogram (ECG): To detect abnormal rhythms
• Cardiac MRI: To view scarring or inflammation
• Stress Testing: To evaluate performance under strain
• Genetic Testing: For inherited forms
• Blood Tests & Holter Monitoring

When needed, we also perform vascular ultrasound to assess blood flow and rule out systemic contributions to heart strain.

Treatment: Tailored to You

There’s no one-size-fits-all solution. Your treatment depends on the type, severity, and underlying cause of your cardiomyopathy. Options may include:

Medications

• Beta-blockers and ACE inhibitors
• Diuretics to reduce fluid
• Antiarrhythmics
• Anticoagulants for clot prevention

Procedures

• Pacemaker or defibrillator (ICD) insertion
• Septal myectomy for HCM
• Heart transplant in advanced cases

Lifestyle Interventions

• Low-sodium, heart-healthy diet
• Guided exercise programs
• Weight and blood pressure control
• Stress management