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Cardiomyopathy (dilated, restrictive, arrhythmogenic)

Cardiomyopathia · Kardiomyopatie (dilatační, restriktivní, arytmogenní)

What it is

The heart muscle itself is diseased: stretched and weak (dilated — inherited, after myocarditis, alcohol, chemotherapy or pregnancy), stiff (restrictive, often amyloid) or replaced by fat and scar (arrhythmogenic). The hypertrophic form has its own entry.

Symptoms & signs

  • Breathlessness
  • swelling of the legs
  • tiredness
  • palpitations
  • fainting or sudden cardiac death, above all in the arrhythmogenic form

🚩 Get help if…

  • call 112 / 911 now Fainting, especially during exercise
  • call 112 / 911 now Chest pain or a racing, pounding heartbeat
  • call 112 / 911 now Severe breathlessness at rest
  • see a doctor soon Rapid weight gain, ankle swelling or waking up breathless

Where it strikes

Medical treatment

  • Heart-failure quad therapy
  • beta blockers
  • ICD if high risk
  • transplant
  • tafamidis for transthyretin amyloid cardiomyopathy — approved (FDA, EMA 2019–20); fewer deaths and admissions in ATTR-ACT

Natural & lifestyle

  • Stopping alcohol in alcoholic cardiomyopathy
  • competitive endurance sport avoided in the arrhythmogenic form
  • screening of relatives

Emerging & experimental

  • Gene therapy for inherited forms
  • CRISPR trials

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Coenzyme Q10 — mixed trials in dilated cardiomyopathy mixed evidence
  • Thiamine and L-carnitine — deficiency-driven forms respond; otherwise small studies early / small studies
  • Taurine — lab and small studies of heart muscle energy anecdotal / traditional

ICD codes