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When signs point to a disease of the heart muscle, or cardiomyopathy, your physician may have some questions for you and use a variety of tests to make the definitive diagnosis.

There are many different types of cardiomyopathy, so the exact path to diagnosis may vary. You also play an important role, helping the care team by providing information that gives them the clues to reach the right diagnosis.

What questions can I expect my physician to ask?

One of the first questions you might expect is what symptoms you've been having. In advance of your appointment, you might think about or discuss these with a loved one and write down a complete list, including the frequency and circumstances in which you feel symptoms like shortness of breath, a racing heart, or chest pain.

Your physician will also ask about your medical history. Be prepared to list what doctors have diagnosed you with in the past and any recent events like heart attack, hospitalization, or pregnancy.

Why is my doctor asking about my family history?

Your physician will likely ask if you have relatives -- especially parents, siblings, or children -- who have been told they have cardiomyopathy or heart failure or who died suddenly without a known cause. If they have, the chance that you have inherited the same condition is higher.

What might be involved in the physical examination?

Common things a physician will visually check on your body are whether you have swelling in your ankles, feet, legs, or stomach area and if veins in your neck bulge. These can be signs of cardiomyopathy. A stethoscope may be used to listen to the heart and lungs.

What are some tests I can expect?

Diagnostic tests may include:

• Blood tests
• Chest x-ray
• An echocardiogram to show the structure of the heart as it pumps blood
• An electrocardiogram in the office to look at electrical activity of the heart
• Cardiac magnetic resonance imaging (MRI)
• A Holter monitor or other device to assess electrical activity in your heart over a period of a day or more outside the office
• A stress test to monitor the heart while it's beating faster due to exercise or a stimulating medication

With all of this clinical evidence in hand, your physician may strongly suspect a particular type of cardiomyopathy. To confirm the diagnosis, you may need more detailed imaging, a procedure to look inside the heart with use of a catheter (cardiac catheterization and angiography) or, less commonly, you could need a biopsy of the heart or genetic testing.

Read Part 1 of this series: Understanding Your Diagnosis of Cardiomyopathy

"Medical Journeys" is a set of clinical resources reviewed by doctors, meant for physicians and other healthcare professionals as well as the patients they serve. Each episode of this 12-part journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.