Expert insight: Can you lead a normal life with cardiomyopathy?

Written by: Dr Antonis Pantazis
Edited by: Sophie Kennedy

In this informative article on cardiomyopathy, we hear from highly esteemed consultant cardiologist Dr Antonis Pantazis on how the condition is diagnosed and which symptoms patient typically experience. The leading specialist also reveals how cardiomyopathy is treated, when intervention is required and how the condition can affect a person’s everyday life.



What is cardiomyopathy?


Cardiomyopathy is a condition of the heart, more specifically of the heart muscle. It is usually caused by genetic change but environmental or external factors can also play a role. People are not usually born with a cardiomyopathy but they may inherit a predisposition from their parents. Where there is a family history of cardiomyopathy, this can cause a person to have an increased risk of developing the condition later in life.

There are different types of cardiomyopathies. Some cause a thick heart, while others cause a thin or weak heart. Cardiomyopathies are sometimes associated with a lot of symptoms and occasionally with risks of complications. In general, these conditions progress over time and may get worse, but not in all cases. Sometimes, cardiomyopathies stay the same throughout a person’s life and are very mild and subtle, with patients being asymptomatic.


What are the symptoms of cardiomyopathy?


Cardiopathies can cause a variety of symptoms. Sometimes they may manifest with chest pain, breathlessness, palpitations (the feeling of a racing heart) and fainting or near fainting episodes. Most of the time, these symptoms come on with exertion, when patients are engaging in physical activities, but occasionally the symptoms can also occur at rest. A person’s symptoms may change from time to time, or through periods of their life. It is helpful for patients to record their symptoms and the activities they are doing at the time they occur.


Which tests are used to diagnose cardiomyopathy?


There is a long list of tests to investigate suspected cardiomyopathy but not all of them are required for every patient and we don’t perform them all at once. We usually start the investigations with a simple ECG, which is records the electricity of the heart at rest. We also typically look at the heart with scans, most commonly echocardiogram and cardiac MRI. Following this, we move on to monitoring of the rhythm with monitors that are attached to the patient's chest for a period of time, such as a day or two.


Other types of tests may also be used, including provocation tests such as exercise tests and other manoeuvres to provoke changes inside the heart and record them. In general, we are guided by the patient's symptoms, presentation and family history, along with the results of the first tests.


Can you live a normal life with cardiomyopathy?


Many patients with cardiomyopathy live a normal life. Not all patients have debilitating symptoms and some don’t require any particular medical intervention at all. In other cases, patients are able to manage their condition after they receive some medication or undergo a procedure. It’s important that any changes in symptoms and appropriate lifestyle adjustments are discussed with your doctor because there may be certain activities which increase the risk of symptoms and complications in some patients. This depends on the cardiomyopathy in question and the underlying heart condition.


On the other hand, some activities are safer for some patients as compared to others so it's important to individualise the counselling and the discussion about what type of lifestyle each patient should have. This guidance doesn't rule out a life which is near normal and engagement in all kinds of daily activities including jobs, a social life, sports and so on.


How is cardiomyopathy treated?


There are a number of treatment options for patients with cardiomyopathies, which range from medication to interventions and surgical operations. The type of treatment required for each patient is adjusted and individualised depending on their presentation. Sometimes a period of monitoring before any treatment is applied so that the doctor understands exactly what the patient's symptoms are and how they will most likely respond to treatment. Eventually, some of these patients may require certain procedures. Nowadays, a good number of patients undergo efficient treatment which allows them to continue their lives as normal, or as near to normal, as possible.




If you are worried about your heart health and would like to schedule a consultation with Dr Pantazis, you can do so by visiting his Top Doctors profile.

By Dr Antonis Pantazis

Dr Antonis Pantazis is a leading consultant cardiologist who has many years of experience working within the field of cardiomyopathies. He possesses a special interest in the clinical manifestation of the cardiomyopathies (heart muscle condions), their arrhythmogenic manifestation, the risk prevention and the genetic causes of cardiomyopathies.

Additionally, he has a major interest in the cardiac manifestation of neuromuscular conditions, as well as the interaction between sports and cardiac conditions. He also has great experience in pericardial diseases.
Dr Pantazis also has an interest in the cardiac imaging diagnostic modalities, and more particularly uses advanced echocardiography imaging in his practice in order to investigate complex heart conditions, including valve diseases and ischaemic heart disease.

Dr Pantazis sees patients who have suspected or confirmed diagnosis of heart muscle and/or pericardial conditions. He also sees patients who may have cardiac symptoms which have not yet been attributed to any pathology. He offers detailed diagnosis, personalised treatment and guides them through interventional management, when required. His practice also covers investigating the diagnosis of the inherited conditions in the family members with genetic and clinical tests.
Dr Pantazis has also been leading the Hospital’s programme for the medical (non-invasive) and invasive management of the left ventricular outflow tract obstruction in hypertrophic cardiomyopathy. Left ventricular outflow tract obstruction (LVOTO) is a complex dynamic pathology inside the heart which is responsible for significant symptoms such as breathlessness and chest pain on exertion, palpitations, light-headedness and fainting. Its management requires expertise and patient-specific approach. He runs dedicated clinics for arrhythmogenic cardiomyopathy (ARVC), and cardio-neuromuscular diseases.
Dr Pantazis started working as a consultant cardiologist in the cardiomyopathy service of the Heart Hospital, University College London Hospitals NHS Foundation Trust (UCLH) from 2007. He has been the leading cardiologist at UCLH's neuromuscular complex care centre (NMCCC) in The National Hospital for Neurology and Neurosurgery and the academic lead for echocardiography at the Institute for Cardiovascular Science, University College London (UCL).
He has been a consultant cardiologist at The Royal Brompton & Harefield NHS Foundation Trust since 2015 and the Trust's clinical lead for cardiomyopathy and inherited cardiovascular conditions. He is also the head of the echocardiography department at North Middlesex Hospital. He has held the position as Consultant Cardiologist at the Royal Brompton Hospital since 2016. 
Dr Pantazis is an educational and clinical supervisor to junior doctors. He is responsible for various educational activities in his scientific field, both nationally and internationally.
He continues to be involved in research related to phenotype/genotype manifestation of hypertrophic, dilated and arrhythmogenic cardiomyopathy and of left-ventricular non-compaction cardiomyopathy. He has special research interest in the mechanisms and treatment of LVOTO in hypertrophic cardiomyopathy, disease progression and risk in arrhythmogenic (ARVC) cardiomyopathy, the cardiac phenotype in Friedreich's ataxia and the cardiac expression of neuromuscular diseases,. His research has been funded by a number of international grants and his cardiomyopathy-related research outcomes have been published in various peer-reviewed journals.
He is also an invited speaker at many national and international meetings. Dr Pantazis contributed to cardiac recommendations on Friedreich's ataxia for Ataxia UK and is also an active supporter of charities, including Cardiomyopathy UK. He is current Chairman of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases and from this position organises and contributes to international publications and educational activities of high impact.

Additionally to the above services, Dr Pantazis offers second and expert opinions in complex cases on request.

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