Description

Cardiomyopathy (kahr-dee-o-my-OP-uh-thee) is a disease of the heart muscle. Makes the heart has a harder time pumping blood to the rest of the body, which can lead to symptoms of heart failure. Cardiomyopathy can also lead to some other serious diseases of the heart.

There are several types of cardiomyopathy. The main types include dilated, hypertrophic and restrictive cardiomyopathy. The treatment includes medications and sometimes surgically implanted devices and heart surgery. Some people with severe cardiomyopathy needs a heart transplant. The treatment depends on the type of cardiomyopathy, and how serious it is.

Symptoms

Some people with cardiomyopathy have no symptoms. For others, the symptoms appear as the condition worsens. Cardiomyopathy symptoms may include:

  • Shortness of breath or shortness of breath with activity or even at rest.
  • Pain in the chest, especially after physical activity or heavy meals.
  • Heartbeats that feel rapid, pounding or fluttering.
  • Swelling of the legs, the ankles, the feet, in the area of the stomach and the neck veins.
  • The swelling of the stomach area due to the accumulation of fluid.
  • Cough while lying down.
  • Trouble going to sleep.
  • Fatigue, even after resting.
  • The dizziness.
  • Fainting.

The symptoms tend to get worse if not treated. In some people, the disease gets worse quickly. In others, it can not get worse for a long time.

When to see a doctor

Consult your health care professional if you have any of the symptoms of cardiomyopathy. Call 911 or the local emergency number if you faint, have difficulty breathing or pain in the chest that lasts more than a couple of minutes.

Some types of cardiomyopathy can be passed down through the families. If you have the disease, your health care professional may recommend that the members of his family to be tested.

Causes

Often, the cause of the cardiomyopathy is not known. But some people get it due to another condition. This is known as an acquired cardiomyopathy. Other people are born with cardiomyopathy due to a gene that is passed on from the parents. This is called inherited cardiomyopathy.

Certain health conditions or behaviors that can lead to acquired cardiomyopathy include:

  • Long-term high blood pressure.
  • The tissue of the heart damage from a heart attack.
  • Long-term rapid heart rate.
  • Heart valve problems.
  • COVID-19 infection.
  • Certain infections, especially those that cause inflammation of the heart.
  • Metabolic disorders, such as obesity, thyroid disease or diabetes.
  • The lack of essential vitamins or minerals in the diet, such as thiamin (vitamin B-1).
  • Complications in pregnancy.
  • Iron accumulation in the heart muscle, called hemochromatosis.
  • The growth of small masses of inflammatory cells called granulomas in any part of the body. When this happens in the heart or lungs, it is called sarcoidosis.
  • The accumulation spot of the proteins in organs, called amyloidosis.
  • Connective tissue disorders.
  • Drinking too much alcohol over a period of many years.
  • The use of cocaine, amphetamines or anabolic steroids.
  • The use of some chemotherapy drugs and radiation to treat cancer.

Types of cardiomyopathy include:

  • Dilated cardiomyopathy.In this type of cardiomyopathy, the chambers of the heart are thin and stretch, getting bigger and bigger. The condition tends to begin in the heart's main pumping chamber called the left ventricle. As a result, the heart has difficulty pumping blood to the rest of the body. This type can affect people of all ages. But it is more common in people younger than 50 years and is more likely to affect men. Conditions that can lead to a dilation of the heart, including coronary artery disease and heart attack. But for some people, the changes in the genes play a role in the disease.
  • Hypertrophic cardiomyopathy (hcm).In this type, the heart muscle becomes thicker. This makes it more difficult for the heart to work. The condition mainly affects the muscle of the heart's main pumping chamber. Hypertrophic cardiomyopathy can start at any age. But it tends to be worse if it occurs in childhood. Most people with this type of cardiomyopathy have a family history of the disease. Some changes in the gene have been linked to hypertrophic cardiomyopathy. The condition does not occur due to a heart problem.
  • Restrictive cardiomyopathy.In this type, the heart muscle becomes stiff and less flexible. As a result, it can expand and fill with blood between heartbeats. This least common type of cardiomyopathy can occur at any age. But most often affects older people. Restrictive cardiomyopathy can occur for no known reason, also called an idiopathic cause. Or may be caused by a disease in other parts of the body that affect the heart, such as amyloidosis.
  • Cardiomyopathy arrhythmogenic right ventricular (ARVC). This is a rare type of cardiomyopathy that tends to occur between the ages of 10 and 50. It mainly affects the muscles in the lower right chamber of the heart, called the right ventricle. The muscle is replaced by fat, which may turn into scars. This can lead to problems with the heart's rhythm. Sometimes, the condition consists in the left ventricle as well. ARVC is often caused by changes in genes.
  • Unclassified cardiomyopathy. Other types of cardiomyopathy fall into this group.

Dilated cardiomyopathy. In this type of cardiomyopathy, the chambers of the heart are thin and stretch, getting bigger and bigger. The condition tends to begin in the heart's main pumping chamber called the left ventricle. As a result, the heart has difficulty pumping blood to the rest of the body.

This type can affect people of all ages. But it is more common in people younger than 50 years and is more likely to affect men. Conditions that can lead to a dilation of the heart, including coronary artery disease and heart attack. But for some people, the changes in the genes play a role in the disease.

Hypertrophic cardiomyopathy (hcm). In this type, the heart muscle becomes thicker. This makes it more difficult for the heart to work. The condition mainly affects the muscle of the heart's main pumping chamber.

Hypertrophic cardiomyopathy can start at any age. But it tends to be worse if it occurs in childhood. Most people with this type of cardiomyopathy have a family history of the disease. Some changes in the gene have been linked to hypertrophic cardiomyopathy. The condition does not occur due to a heart problem.

Restrictive cardiomyopathy. In this type, the heart muscle becomes stiff and less flexible. As a result, it can expand and fill with blood between heartbeats. This least common type of cardiomyopathy can occur at any age. But most often affects older people.

Restrictive cardiomyopathy can occur for no known reason, also called an idiopathic cause. Or may be caused by a disease in other parts of the body that affect the heart, such as amyloidosis.

Risk factors

There are many things that can increase the risk of cardiomyopathy, including:

  • The family history of cardiomyopathy, heart failure and sudden cardiac arrest.
  • Long-term high blood pressure.
  • Conditions that affect the heart. These include a past heart attack, coronary artery disease, or an infection of the heart.
  • Obesity, which causes the heart to work harder.
  • Long-term misuse of alcohol.
  • The use of illicit drugs, such as cocaine, amphetamines and anabolic steroids.
  • Treatment with certain chemotherapy drugs and radiation for cancer.

Many diseases also increase the risk of cardiomyopathy, including:

  • Diabetes.
  • Disease of the thyroid.
  • The storage of excess iron in the body, called hemochromatosis.
  • The accumulation of a certain protein in the body, called amyloidosis.
  • The growth of the small patches of inflamed tissue in the organs, called sarcoidosis.
  • Connective tissue disorders.

Complications

Cardiomyopathy can lead to serious medical conditions, including:

  • Heart failure. The heart can't pump enough blood to meet the body's needs. Without treatment, heart failure can be life-threatening.
  • The blood clots. Because the heart is not pumping well, the blood clots may form in the heart. If clots enter the bloodstream, they can block the flow of blood to other organs, including the heart and the brain.
  • Heart valve problems. Because cardiomyopathy can cause the heart to become larger, the heart valves may not close properly. This can cause the blood to flow backward into the valve.
  • Cardiac arrest and sudden death. Cardiomyopathy can lead to irregular heart rhythms that cause you to faint. Sometimes, irregular heartbeat, may be a cause of sudden death if the heart stops beating effectively.

Prevention

Inherited types of cardiomyopathy can't be prevented. Let your healthcare professional know if you have a family history of the disease.

You can help reduce the risk of acquisition of the types of cardiomyopathy, which are caused by other conditions. Take steps to lead a heart healthy lifestyle, including:

  • Stay away from alcohol or illegal drugs such as cocaine.
  • Control of any other conditions, such as high blood pressure, high cholesterol, or diabetes.
  • Eat a healthy diet.
  • Get regular exercise.
  • Get enough sleep.
  • Reduce your stress level.

These healthy habits can also help people with cardiomyopathy hereditary control of their symptoms.

Diagnosis

Your health care professional examines and often ask you questions about your personal and family medical history. You may be asked when symptoms do occur — for example, if exercise triggers your symptoms.

Tests

The tests to diagnose a cardiomyopathy can include:

  • Blood tests. Blood tests may be done to check the levels of iron and to see how well the kidney, thyroid and liver are working. A blood test can measure a protein produced in the heart called B-type natriuretic peptide (BNP). A blood level of BNP may increase during heart failure, a common complication of cardiomyopathy.
  • X-ray of the chest. An x-ray of the chest shows the condition of the lungs and the heart. They can show if the heart is enlarged.
  • The echocardiogram. Use sound waves to create images of the beating heart. This test can show how blood flows through the heart and the heart valves.
  • Electrocardiogram (ECG). This quick and painless test that measures the electrical activity of the heart. Sticky patches called electrodes are placed on the chest and sometimes the arms and legs. The wires connect the electrodes to a computer, that prints or displays the results of the test. An ECG can show the rhythm of the heart and how slow or fast the heart is beating.
  • The stress tests. These tests often involve walking on a treadmill or pedaling a stationary bike while the heart is controlled. The tests show how the heart responds to exercise. If you can't do the exercise, you may administer a drug that increases the heart rate as you exercise. Sometimes echocardiogram is performed during a stress test.
  • The cardiac catheterization.A thin tube called a catheter is placed in the groin and threaded through the blood vessels of the heart. The pressure within the heart chambers can be measured to see how forcefully pumped the blood through the heart. Contrast dye may be injected through the catheter into the blood vessels to make them easier to see on x-rays. This is called a coronary angiography. Cardiac catheterization can reveal blockages in the blood vessels. This test may also include the removal of a small sample of heart tissue to a lab for verification. That procedure is called a biopsy.
  • CardiacMRI. This test uses magnetic fields and radio waves to create images of the heart. This test may be done if the images from an echocardiogram are not sufficient to confirm the cardiomyopathy.
  • CardiacCTscan. A series of X-rays are used to create images of the heart and the chest. The test shows that the size of the heart and the heart valves. A ct scan of the heart can also show calcium deposits and blockages in the arteries of the heart.
  • Genetic testing or screening. Cardiomyopathy can be passed down through the families, also called cardiomyopathy hereditary. Ask your health care professional if genetic testing is right for you. The family screening or genetic testing may include first-degree relatives (parents, siblings and children.

The cardiac catheterization. A thin tube called a catheter is placed in the groin and threaded through the blood vessels of the heart. The pressure within the heart chambers can be measured to see how forcefully pumped the blood through the heart. Contrast dye may be injected through the catheter into the blood vessels to make them easier to see on x-rays. This is called a coronary angiography. Cardiac catheterization can reveal blockages in the blood vessels.

This test may also include the removal of a small sample of heart tissue to a lab for verification. That procedure is called a biopsy.

Treatment

The objectives of the cardiomyopathy treatment are:

  • Manage the symptoms.
  • To keep the condition from getting worse.
  • Decrease the risk of complications.

The type of treatment depends on the type of cardiomyopathy, and how serious it is.

Drugs

Many types of medicines are used for the treatment of cardiomyopathy. Medications for cardiomyopathy can help:

  • Improve the heart's ability to pump blood.
  • Improve the flow of blood.
  • Lower blood pressure.
  • A slow heart rate.
  • Remove excess fluid and sodium from the body.
  • Prevent blood clots.

Therapies

Forms for the treatment of the cardiomyopathy, or an irregular heartbeat without surgery include:

  • The ablation Septal. This is reduced to a small part of the thickening of the heart muscle. It is an option for the treatment of hypertrophic cardiomyopathy. A doctor threads a thin tube called a catheter into the affected area. Then, the alcohol flows through the tube into the artery that sends blood to that area. The ablation Septal allows the blood to flow through the area.
  • Other types of ablation. A doctor places one or more catheters into the blood vessels of the heart. The sensors on the catheter tips using heat or cold energy to create small scars on the heart. The scars of blocks of irregular heart signals and restore the heartbeat.

Surgery or other procedures

Somes types of devices can be placed in the heart with the surgery. They can help the heart work better and to relieve the symptoms. Helps to prevent complications. Types of cardiac devices include:

  • Ventricular assist device (VAD). A lack of vitamin a that helps pump blood from the lower chambers of the heart to the rest of the body. It is also called a mechanical circulatory support device. More often, a VAD is considered after less invasive treatments do not help. Can be used as a long-term treatment or as a short-term treatment while waiting for a heart transplant.
  • Pacemaker. A pacemaker is a small device that's placed in the chest to help control your heartbeat.
  • Cardiac resynchronization therapy (CRT) device. This device can help the chambers of the heart to squeeze in a more organized and efficient. It is a treatment option for some people with dilated cardiomyopathy. It can help those with ongoing symptoms, along with signs of a condition called left bundle branch block. The condition causes a delay or obstruction along the pathway that electrical signals travel to make the heart beat.
  • An Implantable cardioverter defibrillator (ICD). This device can be recommended to prevent sudden cardiac arrest, which is a dangerous complication of cardiomyopathy. An ICD tracks heart rate, and given electric shocks when necessary, to control irregular heart rhythms. An ICD does not treat cardiomyopathy. Rather, the clocks and controls of irregular rhythms.

Types of surgery used for the treatment of cardiomyopathy include:

  • Septal myectomy. This is a type of open-heart surgery that may be the treatment of hypertrophic cardiomyopathy. A surgeon removes part of the thickening of the muscular wall of the heart, called a septum that separates the last two chambers of the heart, called the ventricles. Removal of a part of the heart muscle improves the flow of blood through the heart. It also improves a type of heart valve disease called mitral valve regurgitation.
  • Heart transplant. This is a surgery to replace a diseased heart with a donor heart healthy. You can be a treatment option for end-stage heart failure, when medications and other treatments do not work.

Lifestyle and home remedies

These lifestyle changes can help manage the cardiomyopathy:

  • Do not smoke. If you smoke, stop smoking. You can ask your healthcare provider for help.
  • Lose weight if overweight. Ask your care team what is a healthy weight for you.
  • Get regular exercise. Talk with your healthcare provider about the safest in the type and amount for you.
  • Eat a healthy diet. Include a variety of fruits, vegetables and whole grains.
  • Use less salt. Cut out the foods that are high in sodium. Less than 1,500 milligrams of sodium per day.
  • Avoid or limit consumption of alcohol.
  • Manage stress.
  • Get enough sleep.
  • Take all medications as prescribed.
  • Get health checkups.

Preparing for your appointment

If you think you may have cardiomyopathy or you are concerned about your risk, make an appointment with your health care professional. You may be referred to a medical center, also called a cardiologist.

Here is the information to help you prepare for your appointment.

What you can do

Be aware of the restrictions that your health care professional wants to follow prior to your appointment. When you make the appointment, ask if there is something that you need to do in advance, such as avoiding certain foods or beverages.

Make a list of:

  • Their symptoms. Include any that do not appear to be associated with cardiomyopathy. Note when your symptoms began.
  • Important personal information. Include any family history of cardiomyopathy, heart disease, stroke, high blood pressure or diabetes. Also note any major stresses or recent life changes.
  • All the medications, vitamins, or other supplements you are taking, including the dosage.
  • Questions to ask your health care team.

Have a family member or friend, if you can. This person can help you remember the information they give you.

In cardiomyopathy, some basic questions to ask your health care professional include:

  • What is the most likely cause of my symptoms?
  • What are other possible causes?
  • What tests do I need?
  • What treatment options are available, and which do you recommend for me?
  • How often should I be tested for cardiomyopathy?
  • Should I tell my family members to be tested in the cardiomyopathy?
  • I have other health conditions. How can I best manage these conditions?
  • Are there brochures or other printed material I can have? What sites do you recommend?

What to expect from your doctor

Your health care team is likely to ask questions such as:

  • Do you have symptoms all the time, or come and go?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Cardiomyopathy