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Things that could lead to acquired cardiomyopathy include: Autoimmune diseases that affect your connective tissues, such as lupus, rheumatoid arthritis, and scleroderma Chemotherapy Diabetes and other metabolic disorders High blood pressure Heart disease or coronary artery disease Infections such as COVID-19, hepatitis, and HIV Muscular dystrophy Pregnancy complications Overuse of alcohol, amphetamines, anabolic steroids, or cocaine Sarcoidosis (the buildup of inflammatory cells in your heart) Thyroid diseases Vitamin or mineral deficiencies Sometimes, doctors don’t know what caused cardiomyopathy