Cardiomyopathy is a disease of the heart muscle that may becomes stretched (enlarged) or abnormally thick or rigid. Sometimes extensive scarring occurs.

There are three types of cardiomyopathy:

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The terms Systolic or Diastolic dysfunction are often used to describe where in your heart cycle this occurs:

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A dilated cardiomyopathy can be inherited or caused by a variety of diseases that include:

  • Coronary artery disease and previous heart attacks (ischemic cardiomyopathy)
  • Infections, especially viral infections that cause the heart muscle to become inflamed (myocarditis)
  • Alcohol, especially when a person has a poor diet (alcoholic cardiomyopathy)
  • Complications during the last month of pregnancy or within 5 months of birth (peripartum cardiomyopathy)
  • Certain drugs, such as cocaine, amphetamines, and some cancer medications
  • Diseases such as diabetes and thyroid disease

Causes of Diastolic Dysfunction and Heart Failure

Common causes*

Cardiac ischemia




Aortic stenosis

Uncommon causes

Myocardial disorders


Myocardial diseases



Infiltrative disease (e.g., amyloidosis, sarcoidosis, fatty infiltration)



Noninfiltrative diseases (e.g., idiopathic and hypertrophic cardiomyopathy)


Endomyocardial diseases



Hypereosinophilic syndrome


Storage diseases



Glycogen storage disease




Pericardial disorders


Constrictive pericarditis


Effusive-constrictive pericarditis


Pericardial effusion

*—Common causes are listed in order of prevalence.

What may lead to Diastolic Heart Failure


When treating a patient with diastolic dysfunction, it is important to control the heart rate and prevent tachycardia to maximize the diastolic filling period. Beta blockers are particularly useful for this purpose; however, they do not directly affect myocardial relaxation. In addition to slowing heart rate, beta blockers have proven benefits in reducing blood pressure and myocardial ischemia, promoting regression of left ventricular hypertrophy, and antagonizing the excessive adrenergic stimulation during heart failure. Beta blockers have been independently associated with improved survival in patients with diastolic heart failure. These medications should be used to treat diastolic heart failure, especially if hypertension, coronary artery disease, or arrhythmia is present.

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A hypertrophic cardiomyopathy can also be inherited, but it usually is the result of long-standing high blood pressure.

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Restrictive cardiomyopathy may occur as a result of:

  • Hemochromatosis, a condition in which too much iron is deposited into tissues, including heart tissue
  • Amyloidosis, a disease in which abnormal proteins are deposited into heart tissue
  • Sarcoidosis, a disease in which inflammation produces tiny lumps of cells in various organs in the body, including the heart
  • Connective tissue disorders

 Not everyone with cardiomyopathy needs treatment and some patients recover on their own. Patients without symptoms may not need treatment.

For symptoms, diagnosis and treatment, please refer to the section on heart failure.

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