Symptoms

For people with dilated or restrictive cardiomyopathy, it may take years before the symptoms develop. Some people never develop symptoms. For others, the symptoms can develop gradually over a period of years or appear suddenly, following a flu-like illness. As the disease progresses, the heart may continue to weaken with the symptoms increasing, which can significantly decrease the threshold of activity in a person. Sudden death may occur at any stage of the diseases. (For symptoms of hypertrophic cardiomyopathy, which include shortness of breath, chest pain or pressure, fainting, and palpitations, see our hypertrophic cardiomyopathy page.)

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If you develop symptoms, you have what is referred to as heart failure, the most common symptoms of which are:

• Shortness of breath (dyspnea) may occur during activity, while lying down, or while sleeping. Extra fluid accumulating in the lungs or increasing the pressures in the heart chambers causes dyspnea. Initially it may occur only with physical exertion. But as the symptoms progress, dyspnea may also occur with mild activity or when lying down, causing some people to feel more comfortable sleeping with their heads elevated. Some people may even wake up at night feeling short of breath or with a feeling of suffocation due to fluid in the lungs. Severe dyspnea may be accompanied by dry cough or wheezing and can be confused with asthma and other disorders, delaying appropriate diagnosis.
• Fatigue or feeling overly tired with low levels of activity can result when the muscles and brain receive inadequate amounts of oxygen and nutrients due to decreased blood circulation.

Other symptoms that are associated with dilated and restrictive cardiomyopathy include:

• Swelling of the legs and feet (edema) develops due to fluid retention.
• Swelling of the abdomen may develop due to fluid accumulation in the liver, which can cause abdominal pain and loss of appetite.
• Changes in urination can occur. People tend to urinate less during the day to increase body fluids and more frequently at night because the extra fluid accumulating in the body enters the bloodstream when a person lies down.
• Chest pain occurs in about 10 percent of people with dilated cardiomyopathy and occasionally in people with restrictive cardiomyopathy.
• Abnormal weight gain may occur due to accumulation of fluid in the arms, feet, and abdomen.
• Palpitations can feel like your heart suddenly speeds up, skips a beat or misses a beat, or can just be an uncomfortable awareness of your heart beating. Palpitations are a symptom of advanced dilated cardiomyopathy.
• Change in mental alertness can occur due to decreased circulation of oxygen to the brain. This can be described as lightheadedness, dizziness, fainting, decreased alertness, or difficulty concentrating.