Prevention and Treatment of Cardiomyopathy

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.

In other instances, treatment is needed. Treatment hinges on a few factors: the type of cardiomyopathy, the severity of your symptoms and complications as well as your age and overall health.

Treatment goals

When treating cardiomyopathy, objectives include:

• Stopping the disease from getting worse
• Managing any conditions that cause or contribute to the disease
• Reducing complications and the risk of sudden cardiac arrest (SCA)
• Controlling symptoms so that you can live as normally as possible

Treatments for cardiomyopathies

Lifestyle changes

Lifestyle changes may help manage a condition that’s causing your cardiomyopathy.

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 and trans fats. Healthy choices include lean meats, poultry without skin, fish, beans as well as fat-free or low-fat milk and milk products.
• Choose and prepare foods with little salt (sodium). Too much sodium can raise your risk of high blood pressure. Studies show that following a Dietary Approaches to Stop Hypertension (DASH) eating plan can lower blood pressure.
• Choose foods and beverages that are low in added sugar. Avoid drinking alcohol. 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. But talk to your health care professional before increasing your physical activity if you:
  • Take medications.
  • Have an ongoing health problem.
  • Experience symptoms such as chest pain, shortness of breath or dizziness.

Other lifestyle changes

Your health care professional also may recommend other lifestyle changes, such as:

• Quitting smoking 
• Losing excess weight
• Avoiding alcohol and illegal drugs
• Getting enough sleep and rest
• Reducing stress
• Treating underlying conditions, such as diabetes and high blood pressure 

Medications

Many medications are used to treat cardiomyopathy. Your health care professional 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 (abnormal heartbeats).
• Balance electrolytes in your body. Electrolytes are minerals that help maintain fluid levels and the acid-base balance in your body. Electrolytes also help muscle and nerve tissues work properly. Medicines used to balance electrolytes include aldosterone blockers.
• Remove excess fluid and sodium from your body. Diuretics, or “water pills,” help remove excess fluid and sodium from the body.
• Prevent blood clots from forming. Anticoagulants (PDF), or *blood thinners, help prevent blood clots. Blood thinners often are used to prevent blood clots from forming in people who have dilated cardiomyopathy.
• Reduce inflammation. Medications used to reduce inflammation include corticosteroids.

Procedures for cardiomyopathy

A range of surgical and nonsurgical procedures can be used to treat cardiomyopathy:

• Septal myectomy: This open-heart surgery is considered for people who have obstructive hypertrophic cardiomyopathy and severe symptoms. This surgery generally is reserved for younger patients and for people whose medications aren’t working well. A surgeon removes part of the thickened septum that’s bulging into the left ventricle. This improves blood flow within the heart and out to the body.
• Surgically implanted devices: Surgeons can implant several types of devices in the body to help the heart work better, including:
  • Pacemaker: This small device uses electrical pulses to prompt the heart to beat at a normal rate.
  • Cardiac resynchronization therapy (CRT) device: This device coordinates contractions between the heart’s left and right ventricles.
  • Left ventricular assist device (LVAD): This implantable device helps the heart pump blood to the body. An LVAD can be used for long-term therapy or as an interim treatment for those awaiting a heart transplant.
  • Implantable cardioverter defibrillator (ICD): An ICD helps maintain a normal heartbeat by sending an electric shock to the heart if an arrhythmia is detected.
• Heart transplant: A person’s diseased heart is replaced with a healthy donor heart. A heart transplant is a last resort for people who have end-stage heart failure. (End-stage means that all other treatment options have been explored, without success.)
• Alcohol septal ablation (nonsurgical procedure): Ethanol (a type of alcohol) is injected through a tube into the small artery that supplies blood to the area of heart muscle thickened by hypertrophic cardiomyopathy. The alcohol causes these cells to die. The thickened tissue shrinks to a more normal size. The risks and complications of heart surgery increase with age. For this reason, ablation may be preferred to myectomy in older patients with other medical conditions.

How can cardiomyopathy be prevented?

You can't prevent inherited types of cardiomyopathy. But you can take steps to lower your risk for conditions that may lead to (or complicate) cardiomyopathy, such as coronary heart disease, high blood pressure and heart attack.

Cardiomyopathy can be precipitated by an underlying disease or condition. Treating that initial problem early enough may help prevent the complications presented by cardiomyopathy. For example, to control the underlying conditions of high blood pressure, high blood cholesterol and diabetes:

• Get regular checkups with your health care professional.
• Follow your health care professional's advice about lifestyle changes.
• Take all your medications exactly as prescribed.

Just as some underlying conditions can bring about cardiomyopathy, cardiomyopathy can cause other complications.

For instance, cardiomyopathy can increase the risk for sudden cardiac arrest (SCA). An implantable cardioverter defibrillator (ICD) can lessen this risk.