Cardiomyopathy vs. heart failure: What is the difference?

Share on Pinterest

Cardiomyopathy is a group of diseases that affect the heart muscle, making it more difficult for the heart to pump blood efficiently. The heart muscle may become enlarged, thickened, or stiff, affecting its pumping function.

Not everyone with cardiomyopathy experiences symptoms, but when symptoms do develop, it means they have heart failure. The symptoms of heart failure include:

• shortness of breath
• persistent cough
• chest pain
• swelling in the legs
• irregular heartbeat

Heart failure is a broader term that describes the inability of the heart to pump blood effectively to meet the body’s demands. It can result from cardiomyopathy.

Learn more about heart failure.

It is possible to have cardiomyopathy without heart failure. Some people with cardiomyopathy never develop symptoms and do not require treatment. The heart may still pump enough blood in these cases.

For other people, the cardiomyopathy may worsen over time. It may not lead to heart failure at first but could later on as the condition progresses.

Early detection and appropriate management can help prevent or delay the progression to heart failure in those with cardiomyopathy.

There are several types of cardiomyopathy, such as:

1. Ischemic cardiomyopathy: This type occurs due to a lack of blood flow, which then damages the heart muscle. Coronary artery disease (CAD) is a major cause of ischemic cardiomyopathy.
2. Dilated cardiomyopathy (DCM): This is a common type of cardiomyopathy. It occurs when the heart chambers become larger, which weakens the heart’s pumping ability. DCM often has no clear cause, but it may be genetic, the result of infections, alcohol misuse, or exposure to certain toxins. Most people with DCM will eventually develop heart failure.
3. Hypertrophic cardiomyopathy (HCM): In HCM, the heart muscle becomes thickened, making it harder for the heart to pump blood effectively. HCM is a genetic condition and can lead to complications such as arrhythmias and sudden cardiac death.

Some rarer types of cardiomyopathy include:

• arrhythmogenic right ventricular cardiomyopathy (ARVC)
• restrictive cardiomyopathy
• left ventricular noncompaction
• takotsubo cardiomyopathy, or broken heart syndrome

Learn more about inherited cardiomyopathy.

In cases of HCM and ARVC and certain types of DCM, cardiomyopathy is genetic. It occurs when people inherit certain genes that lead to the condition.

However, a person can also acquire cardiomyopathy, meaning they develop the condition over time. Risk factors that may contribute to acquired cardiomyopathy include:

• heart inflammation, such as myocarditis or pericarditis
• chronic high blood pressure
• exposure to toxins or certain medications
• long-term alcohol consumption
• metabolic conditions, such as diabetes and obesity
• other conditions that affect the heart, such as CAD or heart attack
• conditions that affect muscle function, such as muscular dystrophy
• illicit drug use, such as cocaine, amphetamines, and anabolic steroids
• infections such as HIV and viral hepatitis
• treatment with certain chemotherapy medications or radiation for cancer
• intense stress, which can cause takotsubo cardiomyopathy

In many cases of DCM, there is no clear cause of cardiomyopathy. Sometimes, a person with DCM has a family history of cardiomyopathy. However, unless doctors identify a specific genetic link, most cases are idiopathic, meaning doctors cannot identify a cause.

It is possible for the heart to recover from certain types of cardiomyopathy. However, this depends on the cause and whether the person has symptoms.

Symptoms in cardiomyopathy mean a person has heart failure. Once someone has developed heart failure, they will always have this condition.

Treating the underlying cause may reduce the symptoms, helping the heart to function better. However, the person will still require monitoring and may need medications to keep the heart healthy long term.

Sometimes, the heart may partially recover with appropriate management, including:

• medications to improve heart function and manage symptoms
• lifestyle modifications such as a heart-healthy diet, regular exercise, and avoiding alcohol and tobacco if applicable
• cardiac rehabilitation
• implantation of devices such as pacemakers or defibrillators
• surgical procedures such as septal myectomy in severe cases

While some cases of cardiomyopathy may progress and lead to heart failure or other complications, others can be manageable with the necessary lifestyle changes, medications, and other treatments.

The life expectancy of people with cardiomyopathy varies widely depending on factors such as the type and severity of the condition, overall health, and response to treatment.

A 2022 study of 166 adults with DCM found there was a 15-year survival rate of 34%. However, this included death by any cause, not just from cardiomyopathy, and the mean age of the participants was 59.5 years of age.

With standard treatment and management, the 5-year survival rate was 44%. Overall, the researchers found that survival rates had improved compared with previous data. They may continue to improve with better treatments and consistent monitoring.

Here are some common questions about cardiomyopathy.

Is cardiomyopathy the same as congestive heart failure?

Cardiomyopathy and congestive heart failure are not the same. Cardiomyopathy refers to diseases that affect the heart muscle. Congestive heart failure is a condition where the heart is unable to pump blood effectively to meet the body’s needs, resulting in symptoms.

Can you live a long life with cardiomyopathy?

This largely depends on the type of cardiomyopathy a person has, how severe it is, and how they respond to treatment.

Some types of cardiomyopathy are more likely to improve with treatment. For example, if the cause is high blood pressure and a person receives treatment early, the effects on the heart may decrease.

Treatment makes a significant difference to survival. For example, regular cardiac rehabilitation can decrease death rates due to DCM by 20%.

“Cardiomyopathy” refers to a group of conditions that make the heart muscle less effective in pumping blood. “Heart failure” is a broader term for when a person has symptoms due to the heart not pumping enough blood.

While cardiomyopathy can lead to heart failure that causes symptoms, not all cases progress to this stage.

Treatment for cardiomyopathy depends on the extent of the symptoms and the type and usually consists of lifestyle changes and medications. Treatment in more severe cases may include implanted devices or surgery.

Early detection, appropriate management, and adherence to treatment recommendations are key to improving the outlook.