What does it mean when your doctor writes “Non-Ischemic Cardiomyopathy” on your chart?

Background Information

• Non-Ischemic cardiomyopathy is a generic term which includes all causes of decreased heart function other than those caused by heart attacks or blockages in the arteries of the heart.
• The most common causes of non-ischemic cardiomyopathy are viral infection (viral myocarditis), drug reactions, inflammation or autoimmune reactions (lupus myocarditis, etc) or infiltrative processes (sarcoid, amyloid, etc).
• Normal heart function, or ejection fraction (EF), is 55-65%. This means that with each beat, the heart pumps 55-65% of the blood inside the heart to the rest of the body.

Cardiomyopathy implies some decrease in EF to less than 50% (which is considered borderline or low normal.)

Symptoms

• Shortness of breath
• Edema or swelling
• Fatigue, especially with exertion
• Unexplained weight gain
• Shortness of breath when lying down

Diagnostic Tests

• Ultrasound of the heart (Echocardiogram)
• Stress testing (occasionally)
• Angiogram (rarely)
• Some blood tests may be helpful in making the diagnosis

Treatment

• Beta-blockers (atenolol, metoprolol, carvedilol, etc) can relax the heart, lower blood pressure and slow the heart to improve filling and pumping function.
• Medications classified as ACE-inhibitors (lisinopril, enalapril, etc) or ARB’s (losartan, candesartan, etc) can also lower blood pressure, relax the heart and improved blood flow to the kidney.
• Diuretics may be used to remove excess fluid.
• Spironolactone can also be used to remove fluid and help relax the heart.
• Pacemakers or defibrillators may be recommended in some cases.
• Other treatments may be considered depending on the cause of the cardiomyopathy