Cardiomyopathy

Symptoms

• Shortness of breath (dyspnea)
  • Need for extra pillows to sleep - lying flat causes shortness of breath
  • Waking up at night with sudden shortness of breath (paroxysmal nocturnal dyspnea)
• Cough - may be caused by extra liquid accumulating in the lungs, secondary to heart failure
• Fatigue (decreasing ability to tolerate physical exertion)
• Swelling of legs or ankles (edema)
• Abdominal swelling
• Chest pain - also known as "angina," consists of a feeling of sharp, unrelenting pressure the middle of the chest (more common in ischemic cardiomyopathy)
• Palpitations - the sensation of feeling the heart beat
• High blood pressure
• Fainting - especially after activity; temporary and brief loss of consciousness
• Light-headedness - especially after activity
• Dizziness
• Low amount of urine during daytime
• Need to urinate at night
• Difficulty concentrating
• Decreased alertness
• Loss of appetite
• Deconditioning may occur as a consequence of the other symptoms, leading to a reduction in the heart's muscle mass

Exams and Tests

Examination may reveal an irregular heartbeat. Heart sounds and breath sounds may be abnormal. When heart valve disease is also present, a heart murmur may be detected. Additionally, there may be other signs of heart failure.

Decreased heart function and heart enlargement may appear in these tests:

• Coronary angiography
• Echocardiogram and ultrasound examination of the heart.
• Chest x-ray
• Chest CT scan
• MRI of chest
• ECG

Rarely, a heart biopsy performed during a heart catheterization may be needed to rule out other disorders. The following lab tests may be used to rule out other disorders and to assess the condition of the heart:

• CBC
• Coronary risk profile
• Blood chemistries
• Cardiac enzymes: (CPK isoenzymes, CK-MB, LDH isoenzymes)
• Toxic screen for cocaine