Cardiomyopathy Diagnosis

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Your doctor may screen you for cardiomyopathy if a close relative has this condition or has had another serious heart condition, or if people in your family have died suddenly. Sudden, unexplained death can be a sign of cardiac arrest. Your doctor may also notice signs of cardiomyopathy during a routine exam.

To diagnose cardiomyopathy, your doctor may order one or more tests.

• Blood tests check the levels of certain substances in your blood that are raised when you have cardiomyopathy or complications such as heart failure.
• Heart tests, such as imaging tests, echocardiography, and stress tests, check the size and shape of your heart and how well it is working.
• Genetic testing is important when one or more of your close relatives has cardiomyopathy or another heart condition that runs in families.  A genetic counselor can help you find out if your cardiomyopathy is inherited.

Your doctor may order one of these medical procedures to confirm your diagnosis:

Cardiac catheterization 

Cardiac catheterization is a medical procedure used to diagnose and treat some heart conditions. During cardiac catheterization, a long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin or upper thigh, or neck. The catheter is then threaded to your heart.

Coronary angiography

Coronary angiography is a procedure that uses contrast dye, usually containing iodine, and X-ray pictures to detect blockages in the coronary arteries that are caused by plaque buildup. Blockages prevent your heart from getting oxygen and important nutrients.

This procedure is used to diagnose heart diseases or after abnormal results from tests such as an electrocardiogram (EKG) or an exercise stress test. If you are having a heart attack, coronary angiography can help your doctors plan your treatment.

Coronary angiography is often done in a hospital. You will stay awake, but you will get medicine to relax you during the procedure. Often, coronary angiography is done with a cardiac catheterization procedure. For this, your doctor will clean and numb an area on the arm, groin or upper thigh, or neck before making a small hole in a blood vessel. Your doctor will insert a catheter tube into your blood vessel. Your doctor will take X-ray pictures to help place the catheter in your coronary artery. After the catheter is in place, your doctor will inject the contrast dye through the catheter to highlight blockages and will take X-ray pictures of your heart. If blockages are detected, your doctor may use percutaneous coronary intervention, also known as coronary angioplasty, to improve blood flow to your heart.

After coronary angiography, your doctor will remove the catheter, then close and bandage the opening on your arm, groin, or neck. You may develop a bruise and soreness where the catheter was inserted. You will stay in the hospital for a few hours or overnight. During this time, your healthcare team will check your heart rate and blood pressure.

Coronary angiography is a common procedure that rarely causes serious problems. However, as with any procedure involving the heart, there are risks. These include bleeding, allergic reactions to the contrast dye, infection, blood vessel damage, arrhythmias, and blood clots that can trigger a heart attack or stroke. The risk of complications is higher in people who are older or who have chronic kidney disease or diabetes.

Heart biopsy

A heart biopsy, or myocardial biopsy, is used to diagnose some types of cardiomyopathy. For this test, your doctor will remove a very small piece of your heart muscle to check for signs of cardiomyopathy. This can be done during cardiac catheterization.