Cardiomyopathy: What to know
According to the Centers for Disease Control and Prevention (CDC), cardiomyopathy may occur in as many as 1 in 500 people, but it frequently goes undiagnosed. Cardiomyopathy can develop over time, or a person may have the disease from birth.
Keep reading to learn more about cardiomyopathy, including its symptoms, causes, and treatment.
There are a few types of cardiomyopathy, including the following:
A person with cardiomyopathy may experience shortness of breath and heart palpitations.
The disease often starts in the left ventricle, but it can eventually also affect the right ventricle.
Dilated cardiomyopathy can affect the structure and function of the atria, too.
Hypertrophic cardiomyopathy is a genetic condition in which abnormal growth of the heart muscle fibers occurs, leading to the thickening or "hypertrophy" of these fibers. The thickening makes the chambers of the heart stiff and affects blood flow. It can also increase the risk of electrical disturbances, called arrhythmias.
According to the Children's Cardiomyopathy Foundation, it is the second most common form of cardiomyopathy in children. In about one-third of affected children, diagnosis occurs before the age of 1 year.
Restrictive cardiomyopathy occurs when the tissues of the ventricles become rigid and cannot fill with blood properly. Eventually, it may lead to heart failure. It is more common in older adults and can result from infiltrative conditions — those involving the accumulation of abnormal substances in bodily tissues — such as amyloidosis.
In arrhythmogenic cardiomyopathy, fibrotic and fatty tissue replaces the healthy tissues of the right ventricle, which may cause irregular heart rhythms. In some cases, this process can also occur in the left ventricle.
According to research in the journal Circulation Research, arrhythmogenic cardiomyopathy increases the risk of sudden cardiac death, especially in young people and athletes. It is a hereditary genetic condition.
In some cases, usually mild ones, there are no symptoms of cardiomyopathy.
However, as the condition progresses, a person may experience the following symptoms with varying degrees of severity:
- shortness of breath
- swelling of the legs and ankles
- heart palpitations
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Causes and risk factors
The cause of cardiomyopathy is not always clear, but there are some known risk factors.
For example, conditions that lead to inflammation or damage of the heart can increase a person's risk of cardiomyopathy.
Heart failure, which can occur as a result of a heart attack or other conditions, can also cause cardiomyopathy.
Additional risk factors include:
- a family history of heart disease, sudden cardiac death, or cardiomyopathy
- high blood pressure
- coronary artery disease
- amyloidosis and sarcoidosis, which can damage the heart
- viral infections of the heart
- alcohol use disorder
- some women can have a higher risk of cardiomyopathy after pregnancy
Doctors will carry out a physical exam and diagnostic tests to confirm cardiomyopathy.
They are likely to use one or more of the following diagnostic tests:
- Chest X-ray: A chest X-ray helps determine whether the heart has become enlarged, which is a sign of certain health conditions.
- Electrocardiogram (EKG): An EKG measures the electrical activity of the heart, including how fast it is beating. It also shows whether the heart rhythm is regular or abnormal.
- Echocardiogram: An echo uses sound waves to create a moving image of the heart. It shows the shape and size of the heart.
- Cardiac catheterization: A catheterization checks the flow of blood through the heart's chambers.
The intention of cardiomyopathy treatment is to control symptoms, slow the progression of the condition, and prevent sudden cardiac death. The type of treatment may depend on the severity of the symptoms and the form of cardiomyopathy.
Usually, treatment includes a combination of the following:
Lifestyle changes can help reduce the severity of conditions that may have led to cardiomyopathy. More healthful lifestyle habits may also slow the progression of the disease.
Lifestyle changes may include following a healthful diet, which involves limiting the intake of trans fats, saturated fats, added sugar, and salt.
The quantity and intensity of beneficial physical activity may vary. It is essential to discuss exercise programs with a doctor or another healthcare professional before starting one.
Usually, medications are part of a cardiomyopathy treatment plan. Some types of drugs that doctors may prescribe include:
- Beta-blockers: Beta-blockers slow the heart rate, meaning that the heart has to work less hard.
- Blood thinners: Blood thinners help decrease the risk of blood clots developing.
- Diuretics: Diuretics remove excess fluid from the body. This fluid may accumulate when the heart does not pump efficiently.
- Blood pressure drugs: Angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers, and angiotensin receptor-neprilysin inhibitors help lower blood pressure and interrupt the stress receptors that become activated in people with cardiomyopathy.
- Antiarrhythmics: Antiarrhythmics are medications that prevent abnormal heart rhythms.
Treatment may also include different types of implanted devices. The specific device depends on the symptoms. Implanted devices include:
- Pacemaker: After its surgical implantation beneath the skin near the chest, a pacemaker delivers electrical impulses to the heart, causing it to beat at a normal rate.
- Implantable cardioverter-defibrillator: This device also delivers an electric shock to the heart when it detects an abnormal, potentially unstable heart rhythm. The electrical impulse returns the heart rhythm to normal.
- Left ventricle assist device (LVAD): The LVAD assists the heart in pumping blood throughout the body. When cardiomyopathy has severely weakened the heart, this device is helpful while a person is waiting for a heart transplant.
- Cardiac resynchronization device: This implanted device helps coordinate the contractions of the left and right ventricles of the heart to improve heart function.
When symptoms are severe, surgery might be an option. Some possible surgical procedures for cardiomyopathy include:
This surgery treats hypertrophic cardiomyopathy with obstruction of blood flow. It involves removing part of the septum that is protruding into the left ventricle. Removing the thickened tissue improves blood flow out of the heart.
People with certain forms of cardiomyopathy with advanced heart failure might be eligible for heart transplantation. However, a heart transplant is an extensive process for which not everyone qualifies.
When to see a doctor
Cardiomyopathy is a serious medical condition that requires treatment.
Without treatment, the disease may progress and become life threatening.
Anyone who has a strong family history of cardiomyopathy or experiences one or more of the symptoms of this disease should see a doctor. An earlier diagnosis may improve a person's outlook.
Cardiomyopathy is a disease that involves the weakening of the heart muscle.
There are various forms of cardiomyopathy, including dilated cardiomyopathy, which is the most common.
Treatment for cardiomyopathy depends on the extent of the symptoms, as well as the form of the disease.
Treatment usually consists of lifestyle changes and medications. Additional treatment in more severe cases may include implanted devices or surgery.