Cardiomyopathy is a group of diseases of the heart muscle characterized by structural or functional abnormalities that impair the heartTMs ability to pump blood effectively. Types include dilated, hypertrophic, restrictive, and arrhythmogenic right ventricular cardiomyopathy, each with different causes and prognoses. Symptoms can range from none to severe shortness of breath, fatigue, arrhythmias, and heart failure. Some forms are genetic, while others result from ischemic damage, viral infections, alcohol, or chemotherapy. Cardiomyopathy significantly increases mortality and morbidity risk, and severe cases may require device implantation, transplant, or advanced therapies. For underwriters, it is one of the most serious cardiovascular impairments.

Underwriters evaluate cardiomyopathy by reviewing echocardiograms, MRI reports, ejection fraction measurements, cardiology notes, and any history of hospitalizations, arrhythmias, or syncope. They pay particular attention to ejection fraction percentages, presence of ventricular tachycardia, defibrillator placement, and response to treatment. Many cases, especially with reduced ejection fraction or significant arrhythmias, are declined; others may be postponed until stability is demonstrated. Advisors working with clients who have cardiomyopathy often explore simplified-issue or guaranteed-issue options rather than fully underwritten coverage. Understanding cardiomyopathy helps advisors handle difficult conversations compassionately and avoid unrealistic expectations.