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Cardiomyopathy

Abraham Eisenstein, M.D. |
Cardiomyopathy is a term referring to any disease that prevents the heart to pump blood effectively. There are several causes and several outcomes, from "don't do anything" to life-threatening conditions.

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There are a range of causes for cardiomyopathy, among them a viral infection and a genetic condition, which means you should take care if someone in your family had the same condition. This is a condition that should be monitored closely because some patients have no symptoms and live normally with no treatment at all, but for others cardiomyopathy can develop fast with serious symptoms and with possible serious consequences.

There are several types of cardiomyopathy, let's take a look at them briefly.

Cardiac ischemia is the most common form of cardiomyopathy. It occurs when an artery becomes narrowed or blocked for a short time and blood with oxygen can't reach the heart. Ischemic cardiomyopathy is the loss or weakening of heart muscle tissue caused by ischemia (this causes chest pain known as angina) or silent ischemia (with no pain). In most cases it is caused by coronary artery disease and heart attacks.

Dilated or congestive cardiomyopathy is another common type. It affects the chambers of the heart by weakening their walls. It may be caused by a viral infection of the heart, too much alcohol, cocaine or too much antidepressants. In rare cases it may be caused by pregnancy or connective tissue disease such as rheumatoid arthritis. However, in most cases its cause is unknown.

Hypertrophic cardiomyopathy causes a thickening of the heart's walls. That makes it harder for the heart to pump blood. The most common form of hypertrophic cardiomyopathy, HCM, occurs when the wall between the bottom chambers of the heart becomes enlarged and blocks the flow of blood. HCM is usually an inherited disease. HCM can lead to arrhythmia which can lead to sudden death.

Restrictive cardiomyopathy restricts the heart from stretching properly. That limits the amount of blood that fills the heart's chambers but fortunately this is rare type of cardiomyopathy.

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) or Arrhythmogenic Right Ventricular Dysplasia (ARVD) is a rare type of cardiomyopathy but a leading cause of sudden cardiac death among young people, particularly young athletes. However, it can be present in people at any age, at people that exercise or don't exercise at all.

The most common symptoms of cardiomyopathy are heart palpitations, arrhythmias, fainting, breathlessness upon exertion, and light-headedness. Hypertrophic cardiomyopathy may cause dizziness, fainting, heart murmurs and chest pain. Restrictive cardiomyopathy can cause swelling of the hands and feet.

If you have just one of these symptoms, go and see your doctor. If you have chest pain, fainting or difficulty breathing, ask for immediate medical attention.

Diagnosing cardiomyopathy may require not one but several tests. They include blood tests, electrocardiogram, echocardiogram, angiography, cardiac catheterization, chest x-ray, and exercise electrocardiogram (also known as tht stress test).

There are several treatments available for cardiomyopathy. Those are lifestyle changes, medicines, surgery, devices to correct arrhythmias, and a nonsurgical procedure. These treatments are aimed control symptoms, reduce complications, and stop the disease from getting worse.

If it is treated and controlled, cardiomyopathy requires very few changes in the lifestyle of many patients. However, some sports or activities may be limited or even prohibited. The doctor may order fluid and salt intake restrictions. It is important to follow doctor's advice because with small changes the condition may improve greatly and life can be lived normally.

Surgery may be an option too and for a small number of patients with very advanced cardiomyopathy, a heart transplant may be necessary.


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