How Is Cardiomyopathy Treated?

Not everyone who has  cardiomyopathy needs treatment. People who have no signs or  symptoms may not need treatment. In some cases, 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,  how severe the symptoms and complications are, and your age and overall health. 

The main goals of treating cardiomyopathy are to:

• Manage any conditions that cause or contribute to the disease
• Control signs and  symptoms so that you  can live as normally as possible
• Stop the disease from getting worse
• Reduce complications and the chance of sudden cardiac arrest (SCA) 

Treatments may include lifestyle changes,  medicines, surgery, implanted devices to correct arrhythmias,  and a nonsurgical procedure.

Lifestyle Changes 

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 for 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 while doing physical activity. Be as physically active as you can. 

Some people should get medical advice before starting or increasing physical activity. For example, talk to 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 on following a healthy diet, see  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. 

For more information on physical activity, see NHLBI's "Your Guide to Physical Activity and Your Heart." 

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 

Medicines 

A number of 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 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 (salt) 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.
• Surgery

Several  different types of surgery are used  to treat cardiomyopathy. These include septal myectomy (mi-EK-to-me), implanted  devices to help the heart work better, and  heart transplant.

Septal Myectomy

Septal myectomy is open-heart surgery. It's used  for people who have  hypertrophic obstructive 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 abnormal  heart rhythms. The device uses electrical pulses to prompt the heart to beat at a normal rate. 

Sometimes  doctors choose to use a biventricular pacemaker. This 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, which 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.

Heart Transplant

For this surgery, a doctor replaces a person's diseased heart with a healthy heart from a deceased donor. 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.

Nonsurgical Procedure

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 catheter 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 allows blood to  flow freely through the ventricle,  and symptoms improve.