Symptoms:

• Alström syndrome
• Bulging neck veins
• Cough
• Decreased alertness or concentration
• Failure to thrive (in children)
• Fatigue, weakness, faintness
• Heart failure
• Loss of appetite
• Low urine production
• Need to urinate at night (in adults)
• Pulse may feel irregular or rapid
• Sensation of feeling the heart beat (palpitations)
• Shock
• Shortness of breath, especially with activity
• Shortness of breath occurring after lying down for awhile, or in infants while feeding
• Swelling of feet and ankles (in adults)
• Swelling of the abdomen (in adults)

Note: Symptoms of heart failure often develop gradually. Some chest pain may also be associated with this disease.

Signs and tests:

Cardiomyopathy is usually discovered when the doctor is examining and testing you for the cause of heart failure. Tapping over the heart with the fingers and feeling the area may indicate that the heart is enlarged. Listening to the chest with a stethoscope reveals lung crackles, heart murmur, or other abnormal sounds. The liver may be enlarged. Neck veins may be bulging.

Children will have poor growth, pale skin, difficulty feeding, and weak pulses in the legs and arms.

Heart enlargement, congestion of the lungs, decreased movement/functioning of the heart, or heart failure may show on these tests:

• Cardiac catheterization and coronary angiography
• Chest CT scan or MRI of the heart
• Chest x-ray
• Echocardiogram
• Nuclear heart scan (MUGA, RNV)

An ECG may show conduction disturbances or arrhythmias, including tachycardia, and may indicate enlargement of the ventricles. Heart biopsy may be helpful to distinguish dilated cardiomyopathy from other diseases. Lab tests vary depending on the suspected cause.