Symptoms:

• shortness of breath (dyspnea)
• decreasing ability to tolerate physical exertion
• chest pain: This symptom, also known as angina, consists of oppression in the middle of the chest. It is more common in ischemic cardiomyopathy
• fainting (Syncope), especially after activity: Temporary and brief loss of consciousness
• lightheadedness, especially after activity
• dizziness
• palpitations: Sensation of feeling the heart beat
• high bloodpressure

Additional Symptoms That May Occur:

• swelling of legs, ankles, or other portion of the body
• abdominal swelling or enlargement. Liquid in the abdomen is called "ascites."
• decreased amount of urine during daytime
• need to urinate at night
• fatigue, or reduced activity tolerance
• change in mental status
• decreased alertness
• difficulty concentrating
• cough: This may be caused by extra liquid accumulating in the lungs, secondary to heart failure.
• loss of appetite
• deconditioning may occur as a consequence of the other symptoms, leading to a reduction in the hear’s muscle mass.

Signs and Tests:

Examination may reveal an irregular heartbeat; heart sounds and breath sounds may be abnormal. Additionally, there may be other signs of heart failure.

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

• Coronary Angiography: The study of the coronary arteries, (i.e., the vessels providing blood to the heart muscle). The angiography is done by introducing a catheter through the groin and making it ascend to the heart, then injecting a contrast solution to visualize the coronary arteries.
• Ecardiogram
• Chest X-ray
• Chest CT scan: Computerized tomography of the chest
• MRI of chest: Magnetic resonance imaging of the chest
• ECG: May show enlargement, old MI, ischemic changes, arrhythmias, or other abnormalities.
• A heart biopsy may be needed to rule out other disorders.
  

• CBC: Complete Blood Count. Red and white cells are counted, as well as platelets.
• Coronary Risk Profile: The patient’s risk factors for coronary disease are evaluated. Risk Factors include, but are not limited to, cigarette smoking, lipid profile (particularly cholesterol level), hypertension, diabetes, and physical inactivity.
• Blood Chemistries: CBC, lipid profile, and cardiac enzymes

Cardiac Enzymes: (CPK isoenzymes, CK-MB, LDH isoenzymes)

Treatment:

While every cardiomyopathy may result in heart failure, each case requires specific strategies for recovery. Heart failure is treated with a vigorous blend of patient education, dietary changes, and medications. Possible treatments include:

• Positive inotropic agents: These chemicals help the heart contract. The main agent of this category is digoxin. In-hospital options include dopamine, dobutamine, and milrinone.
• Diuretics: Often called "water pills," diuretics help relieve the fluid overloads in heart failure.
• Vasodilators: These drugs dilate vessels at several levels in the body, reducing the workload for the heart.
• ACE-inhibitors: These treatments act as vasodilators while helping to restore the hormonal balance
• Other drugs include: Angiotensin II receptor blockers, calcium channel blockers, beta-blockers, antiarrhythmic drugs, and anticoagulants.
• Advanced, severe heart failure requires heart transplantation.
• Palliative measures, which can be implemented when a donor becomes available, involve surgical procedures. They include:
• Left Ventricular Assist Device (LVAD): Treatment provides mechanical circulatory support.
• Dynamic Cardiomyoplasty: A procedure in which a skeletal muscle flap, created from a patient’s thoracic muscle, is trained to contract often and "wrapped around" the heart to help it contract
• Biventricular pacing: A pacemaker lead (i.e., cable) is inserted in each ventricle, left and right, to help the heart contract better.

Prognosis:

The outcome varies. The disorder is chronic and the condition may deteriorate rapidly.

Complications: