ESC publishes international guidelines on cardiomyopathies

The European Society of Cardiology (ESC) published Guidelines on cardiomyopathies on 25 August 2023 in European Heart Journal. [1] This is the first international guideline document to include all cardiomyopathy subtypes, and the first time that specific recommendations are made for cardiomyopathies other than hypertrophic cardiomyopathy.


“This pioneering document reflects the advances in genetics and cardiac imaging and the advent of new treatments that target specific causes of disease,” said Guidelines task force chairperson Dr Elena Arbelo of the Hospital Clinic, University of Barcelona, Spain.

“At the core of this new Guideline are patients and their families, starting from the point at which an individual presents with symptoms, or as an incidental finding or because of a family history, and working through the pathway towards making a diagnosis and starting treatment,” said Guidelines task force chairperson Dr Juan Pablo Kaski of University College London, UK.

Cardiomyopathies are conditions that affect the muscle of the heart. They are a group of conditions that can affect the heart’s structure, reduce its ability to pump blood around the body and cause abnormal heart rhythms. Cardiomyopathies can present at any age and affect patients and families across the life course. They are often caused by changes in the genes responsible for how the heart muscle cells function, meaning that they can run in families.

Overall, cardiomyopathies are relatively common, affecting around 1 in every 250 people. Some cardiomyopathies are more common than others, however, and the risks and complications are also variable. Many people have very few, if any, symptoms, but others experience fatigue, shortness of breath, chest pain, palpitations and fainting, and have complications such as stroke or sudden death.

The Guidelines highlight the many areas of diagnosis and management that are shared across cardiomyopathy subtypes and gives specific recommendations for each.

Advice for patients

A dedicated section of the Guidelines provides advice for patients on living with a cardiomyopathy. This includes exercise, diet, alcohol, weight, reproductive issues, sexual activity, medication, vaccination, driving, employment, holidays and travel insurance, and life insurance.

The Guidelines recommend a multidisciplinary approach to patient care, and timely and adequate preparation for transition of care from paediatric to adult cardiomyopathy services. They emphasise the need for integrated care between specialist cardiomyopathy teams and other professionals, including cardiologists, geneticists, genetic counsellors, pathologists and other specialties, as well as close interactions between primary, secondary and tertiary care.

1. 2023 ESC Guidelines for the management of cardiomyopathies. European Heart Journal. 2023.