Cardiomyopathy

What is cardiomyopathy?

Your heart is a powerful muscle that contracts continuously to circulate blood throughout the body. Cardiomyopathy refers to a group of diseases that affect the heart muscle (myocardium), impairing its ability to pump blood effectively. Unlike coronary artery disease, which affects blood supply to the heart, cardiomyopathy involves changes to the muscle tissue itself.

There are several types:

• Dilated cardiomyopathy: the heart chambers enlarge and pump less efficiently.

• Hypertrophic cardiomyopathy: the muscle thickens, reducing flexibility and blood flow.

• Restrictive cardiomyopathy: the heart walls become stiff, limiting filling between beats.

• Arrhythmogenic cardiomyopathy: fatty or fibrous tissue replaces heart muscle, affecting rhythm.

Some forms are inherited; others develop through chronic metabolic strain, inflammation, or lifestyle factors over time.

Symptoms of cardiomyopathy

Common cardiomyopathy symptoms include:

• Shortness of breath, especially during activity or at night

• Unusual fatigue or weakness

• Swelling in feet, ankles, or legs (oedema)

• Irregular or rapid heartbeat (palpitations)

• Chest discomfort, dizziness or fainting spells

• Reduced exercise tolerance

In hypertrophic cardiomyopathy, serious arrhythmias or sudden cardiac death can occasionally be the first manifestation of the disease. This is one reason why people with a known family history of hypertrophic cardiomyopathy, a pathogenic genetic variant, or unexplained sudden cardiac death may be offered structured cardiac screening

What causes cardiomyopathy?

Cardiomyopathy can result from genetic factors, chronic systemic stress, or a combination of both:

• Genetic predisposition: family history of heart muscle disease

• Chronic high blood pressure: long-term strain on the heart

• Coronary artery disease: reduced oxygen supply to heart tissue

• Infections or inflammation: viral or autoimmune injury to the heart

• Diabetes or thyroid imbalance (hypothyroidism/hyperthyroidism): metabolic changes that affect muscle tissue

• Alcohol or drug use: prolonged exposure can weaken heart muscle

• Nutrient deficiencies: low levels of key minerals and antioxidants affecting heart function

• Viral infections and autoimmune inflammation: Myocarditis, inflammation of the heart muscle, can trigger dilated cardiomyopathy, sometimes years after the initial infection.

• Obesity and metabolic syndrome: Excess visceral fat and metabolic dysfunction place sustained strain on cardiac structure and function.

How is cardiomyopathy detected?

Detection combines cardiac imaging, which directly visualises heart muscle structure, with blood tests that assess cardiac strain, metabolic risk, and contributing systemic conditions.

Cardiac MRI: Cardiomyopathy is assessed using a combination of clinical history, ECG and cardiac imaging. Echocardiography is commonly used as an initial imaging test because it can assess heart structure, chamber size, wall thickness, pumping function and blood flow. Cardiac MRI provides more detailed assessment of myocardial structure and tissue characteristics and can be particularly useful when the diagnosis is uncertain or when more detailed characterisation is needed. Elfcare's full body MRI includes imaging of the thorax and may identify some structural cardiac findings, such as marked chamber enlargement or wall thickening, when the heart is adequately visualised.

Blood tests: Blood tests cannot detect cardiomyopathy directly but provide important information about cardiac strain and the systemic conditions most closely linked to its development. Relevant markers in Elfcare's panel include:

• NT-proBNP: a hormone released by the heart when it is under pressure or working harder than normal; elevated levels are an important early signal of cardiac stress and reduced pump function.

• CRP: measures inflammation linked to vascular and cardiac stress.

• Total cholesterol, LDL, HDL, and triglycerides: assess cardiovascular risk and coronary artery health

• HbA1c and glucose: show metabolic control and risk of diabetic heart strain.

• TSH, Free T3, Free T4: thyroid dysfunction, both hypo-and hyperthyroidism, directly affects heart muscle function and rhythm.

• Electrolytes (sodium, potassium, magnesium): essential for heart rhythm and contraction.

Why early detection matters

Cardiomyopathy progresses silently. By the time breathlessness, oedema, or palpitations become noticeable, the heart has often already undergone significant structural change. Catching it early gives more time to manage blood pressure, blood sugar, and cholesterol, and to plan tailored follow-up care with a doctor before symptoms progress further.

How Elfcare can help

Elfcare provides a comprehensive assessment of heart health by combining advanced imaging, detailed blood testing, and body composition analysis to detect early signs of cardiomyopathy and its underlying risk factors.

Full body MRI, thorax and heart: Provides detailed imaging of the heart, identifying structural changes such as chamber enlargement or wall thickening, often before symptoms.

Blood panel: Includes 80+ biomarkers (e.g. NT-proBNP, CRP, lipids, HbA1c, thyroid markers, electrolytes) to assess cardiac strain and metabolic risk.

Body composition analysis: Our AMRA® body composition analysis measures visceral fat and muscle quality to quantify metabolic cardiac risk. By identifying these specific biomarkers, we assess comorbidities, like systemic inflammation and insulin resistance, that drive cardiovascular strain, providing a precision profile of heart health that BMI cannot capture.

If our MRI or blood tests identify a suspicious finding, we take care of further diagnostics or refer you to the appropriate specialist.