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  • Cardiomyopathy

    Cardiomyopathy is a general term for a variety of different conditions that damage the heart muscle. Signs, symptoms, and treatment of cardiomyopathy will depend on the cause. Cardiomyopathy can cause the heart muscle to become thick and stiff and in some cases the muscle is replace with ineffective scar tissue.

    As the condition gets worse, the heart will not be able to pump effectively and heart failure or heart valve problems can develop. The muscle of the heart is also special because it sends electrical currents through it to make the muscle contract and beat, but scar tissue may interfere with the heart’s rhythm causing an arrhythmia or dangerous heartbeat.

    Cardiomyopathy tends to run in families and first degree relatives (brothers, sisters, children) of a patient with cardiomyopathy should be screened for the disease.


  • Causes

    There are four types of cardiomyopathy:

    1. Hypertrophic cardiomyopathy: This type is usually inherited and causes a change or genetic mutation in the proteins that make up the cells of the heart. The condition can also develop over time due to high blood pressure or aging.
    2. Dilated cardiomyopathy: About one third of patients have a genetic predisposition for this type. Other factors that influence development include a history of coronary heart disease, high blood pressure, thyroid disease, diabetes, complications from pregnancy, alcohol and drug abuse. 
    3. Restrictive cardiomyopathy: Tends to develop when heavy metals or other substances are retained in the body causing damage to organs. Hemochromatosis (too much iron in the body) and sarcoidosis (total-body inflammation) are two examples. Some connective tissue disorders, chemotherapy and radiation treatments can also cause it.
    4. Arrhythmogenic right ventricular dysplasia: Medical providers are less sure about what causes this type of cardiomyopathy but there appears to be a genetic link. The right ventricle is replaced by fat causing arrhythmias and poor heart function. It usually occurs in people under the age of 40 and is sometimes responsible for sudden cardiac death in athletes.

    Cardiomyopathy can develop from another disease or illness and others are born with a genetic predisposition for it. Many times it develops without a clear cause and can develop in children or adults.

  • Symptoms

    Many people are unaware that they have cardiomyopathy until the heart weakens and begins to fail. As the condition progresses, the heart can no longer pump blood to meet the body’s needs and heart failure (congestive heart failure) can develop. Symptoms can develop slowly or suddenly and range from mild to severe depending on the cause.

    • Shortness of breath while eating or laying down
    • Fatigue
    • Swelling of the belly (abdomen), feet, legs and ankles
    • Heart murmurs (extra heart sounds)
    • Irregular heartbeats (arrhythmias)
    • Difficulty concentrating
    • Chest pain

    People who have any of these symptoms should see their doctor right away.   

  • Testing and diagnosis

    To diagnose cardiomyopathy, patients will need to see a heart specialist (cardiologist). He or she will take a thorough history including information on anyone in the family who has had heart disease, heart failure or died from a sudden cardiac arrest plus details about your symptoms and when they started. Your doctor will listen closely to your heart to find any heart murmurs or abnormal heart sounds and will also check your feet and legs for swelling.

    There are a variety of additional tests your doctor may order. What tests you have will depend on your medical history and physical examination. These tests may include:

    • Blood work
    • Chest X-rays
    • EKG
    • Holter monitoring
    • Echocardiogram
    • Stress testing
    • Cardiac catheterization
    • Genetic testing  

  • Treatment

    For people who have no symptoms, cardiomyopathy may not require any treatment. For those with symptoms, treatment will be based on the kind of cardiomyopathy you have, what has caused it, your age and overall health. Emphasis will be placed on:

    • Controlling symptoms
    • Treating the cause
    • Slowing disease progression
    • Reducing complications

    Non-surgical treatment

    Most patients will start treatment with lifestyle changes including healthy diet and exercise, weight management, smoking cessation and stress reduction. In addition, medications are often used to treat high blood pressure (hypertension) and diabetes. Drugs can also be helpful in controlling irregular heart rates and rhythms, and fluid pills (diuretics) can help with swelling. What medications you need will depend on your situation.

    Surgical treatment

    When medications are not enough, or symptoms are severe, surgical approaches may help manage your cardiomyopathy. 

    Septal myomectomy

    This open heart surgery allows doctors to remove a piece of thickened tissue that divides the bottom two chambers of the heart (ventricles). This approach is best for younger patients with obstructive hypertrophic cardiomyopathy.

    Assist devices 

    To help the heart pump more efficiently, you may need a pacemaker, VAD, or defibrillator. These machines can control irregular beats and assist the heart while pumping to make sure enough blood gets out to the body. Learn more about assist devices » 

    Ablation

    An alcohol septal ablation is one more way to shrink overgrown tissue that’s blocking blood flow inside the heart. This technique uses ethanol in a tiny tube that is inserted into the thickened area to shrink cells and open more space for blood to flow.

    Heart transplant

    When all other attempts to keep the heart functioning have failed, a patient may enter “end stage heart failure” and need a new heart. A heart transplant replaces an old, sick heart with a new healthy one. Learn more about heart transplant »  


Page last updated: 1/6/2014 11:24:55 AM