Cardiomyopathy

Symptoms & causes Diagnosis & treatment Doctors & departments Care at Vejthani

Overview

Cardiomyopathy is a medical condition that impacts the heart’s muscle, leading to a reduced ability to effectively pump blood to other organs in the body. This, in turn, can result in heart failure.

Dilated, hypertrophic, and restricted cardiomyopathies are the three primary subtypes of cardiomyopathy. The kind of cardiomyopathy and the severity of it determine the type and course of treatment, which may involve drugs, surgically implanted devices, heart surgery, or, in extreme circumstances, a heart transplant. With appropriate treatment, it is possible to slow down the progression of cardiomyopathy and enhance your quality of life.

Cardiomyopathy can affect anyone, regardless of their age, sex, or race. Hypertrophic cardiomyopathy, which is the most common genetic form of this condition, affects approximately 1 in 500 individuals worldwide. Another type of genetic cardiomyopathy affects around 1 in 2,000 to 2,500 people.

Symptoms

Early on in the development of cardiomyopathy, there may be neither indications nor symptoms. However, when the illness worsens, several indications and symptoms, such as:

Dyspnea, or shortness of breath with activity or even when at rest
Rapid, hammering, or fluttering heartbeats
Pressure or discomfort in the chest
Legs, ankles, and foot swelling
Abdominal bloating brought on by a fluid accumulation
Fatigue
Cough while reclined
Difficulty sleeping flat
Lightheadedness, wooziness, and fainting

If not treated, symptoms and signs frequently worsen. It depends on the individual whether the illness becomes worse swiftly or gradually.

In case you notice any signs or symptoms related to cardiomyopathy, it’s advisable to seek medical attention from your doctor. If you experience severe shortness of breath, fainting, or chest pain, it’s recommended to call for emergency assistance or your local emergency number immediately.

Certain types of cardiomyopathy can be inherited and passed down from one generation to another within families. If you have been diagnosed with cardiomyopathy, your doctor may recommend that your family members undergo medical evaluation to check if they have the condition too.

Causes

The reason of cardiomyopathy is frequently unknown. However, in other persons it is either inherited or the outcome of a different condition (acquired).

Acquired cardiomyopathy can result from specific medical conditions or activities like:

Cardiac attack-related cardiac tissue damage
Long term high blood pressure or fast heart rate
Problems of the heart valve
Infections, notably those that cause heart inflammation
COVID-19 infection
Connective tissue disorders
Metabolic conditions such diabetes, thyroid illness, or obesity
A deficiency in diet-related vital vitamins or minerals, such as thiamin (vitamin B-1)
Hemochromatosis, an accumulation of iron in the heart muscle
Sarcoidosis, which causes granulomas, or small lumps of inflammatory cells, can develop in any organ of the body, including the heart and lungs.
Amyloidosis, an accumulation of aberrant proteins in the tissues
Radiation and some chemotherapy medicines are used to treat cancer
Utilization of anabolic steroids, cocaine, or amphetamines
Years of excessive alcohol consumption
Complication during pregnancy

Different forms of cardiomyopathy include:

Dilated cardiomyopathy. The left ventricle, the heart’s primary pumping chamber, dilates in this type of cardiomyopathy and is unable to efficiently pump blood out of the heart.

Although this variety can afflict people of all ages, it tends to affect men more frequently and most frequently affects middle-aged individuals. Coronary artery disease and heart attack are the most common causes of cardiomyopathy. However, genetic mutations can also be a contributing factor.

Hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy is characterized by abnormal thickening of the heart muscle, which can make it harder for the heart to function properly. This condition primarily affects the muscle of the left ventricle, which is the heart’s primary pumping chamber. Although hypertrophic cardiomyopathy can manifest at any age, it usually worsens if it does so in childhood. The majority of those who have this kind of cardiomyopathy have a family history of it. Hypertrophic cardiomyopathy has been connected to some genetic abnormalities.
Restrictive cardiomyopathy. The heart muscle stiffens and loses flexibility with this kind, making it incapable of expanding and filling with blood in between heartbeats. Any age can experience this least prevalent form of cardiomyopathy, however elderly persons are more frequently impacted.

Both idiopathic (occurs for no apparent reason) and diseases that affect the heart, such amyloidosis, can result in restrictive cardiomyopathy.

Arrhythmogenic right ventricular dysplasia. The muscle in the lower right heart chamber (right ventricle) is replaced by scar tissue in this uncommon form of cardiomyopathy, which can cause issues with cardiac rhythm. Genetic changes are frequently the cause.
Unclassified cardiomyopathy. This includes many other forms of cardiomyopathy.

Risk factors

Numerous factors, such as the following, can raise your risk of cardiomyopathy:

Chronic high blood pressure
Chronic alcohol abuse
Being overweight causes the heart to overwork
A history of cardiomyopathy, heart disease, and sudden cardiac death in the family
Heart-related conditions, such as having previously experienced a heart attack, having coronary artery disease, or having an infection in the heart (ischemic cardiomyopathy).
Cancer treatment with specific chemotherapy medications and radiation
The use of illegal drugs like cocaine, amphetamines, and anabolic steroid

Many illnesses, such as the following, increase your risk of cardiomyopathy:

Diabetes
Thyroid disease
Connective tissue disorders
Amyloidosis
Sarcoidosis
Hemochromatosis, a condition in which the body stores extra iron

Diagnosis

If your doctor suspects that you have cardiomyopathy, they will likely perform a physical examination and ask about your personal and family medical history. You may also be asked about the timing of your symptoms, such as whether they worsen during exercise. To confirm the diagnosis of cardiomyopathy, your doctor may conduct several tests, including:

Chest X-ray. The size of the heart will be shown in an image.
Echocardiogram. In this test, sound waves are used to produce images of the heart that display its size and beating patterns. This examination of the heart valves aids in identifying the origin of symptoms.
Electrocardiogram (ECG). Electrode patches are applied to the skin during this non-invasive examination to assess electrical cardiac signals. The electrical activity of the heart can be disturbed by an ECG, which can reveal areas of damage and abnormal cardiac rhythms.
Treadmill stress test. While walking on a treadmill, blood pressure, respiration, and heart rate are observed. This test can assess symptoms, establish exercise capacity, and reveal whether strenuous activity causes irregular heartbeats.
Cardiac catheterization. A tiny tube (catheter) is placed into a blood artery in the groin and guided to the heart. How forcefully blood pumps through the heart can be determined by measuring the pressure within the heart’s chambers. When performing a coronary angiography, blood arteries can be dyed to make them more visible on X-rays. A cardiac catheterization might show blood vessel obstructions.

A tiny tissue sample from the heart may also need to be removed (biopsy) for this test in order to be analyzed in a lab.

Cardiac Magnetic Resonance Imaging (MRI). Radio waves and magnetic fields are used in this procedure to produce images of the heart. If the echocardiography pictures are insufficient for a diagnosis, a doctor may request a cardiac MRI.
Cardiac Computed Tomography (CT) scan. This entails reclining on a table inside a machine. To evaluate the size, function, and condition of the heart and its valves, an X-ray tube inside the machine spins around the body and gathers images of the chest and heart.
Blood tests. Blood tests may be performed for several purposes, such as determining iron levels and evaluating kidney, thyroid, and liver function.

B-type natriuretic peptide (BNP), a protein made in the heart, can be measured by a single blood test. When a person experiences heart failure, a typical cardiomyopathy consequence, their blood level of BNP may increase.

Genetic testing or screening. Cardiomyopathy can be inherited and handed down through families. If you want to know if genetic testing is right for you, go to your doctor. Parents, siblings, and children are first-degree relatives who may be subjected to genetic testing or family screening.

Treatment

The goals of cardiomyopathy treatment are to:

Control symptoms and signs
Stop the condition from getting worse.
Lower the possibility of complications

The treatment approach for cardiomyopathy depends on the type and severity of the condition.

Medications

Medications are a common treatment option for cardiomyopathy. These medications may work by:

Boost blood pumping capacity of the heart and blood flow
Decrease blood pressure
Decrease heart rate
Get rid of excess body fluid
Avoid clotting of blood

Therapies

The following nonsurgical techniques are used to treat cardiomyopathy or arrhythmia:

Septal ablation. In alcohol septal ablation, a catheter (a long, thin tube) is used to inject alcohol into the artery that supplies blood to the thickened heart muscle. This causes a small portion of the muscle to be destroyed, allowing blood to flow more freely in the area.
Radiofrequency ablation. Medical professionals can use long, flexible tubes (catheters) to treat irregular heartbeats by inserting them into the heart’s blood vessels. The catheter’s tip is equipped with electrodes that can be used to target and damage a small area of cardiac tissue that is responsible for the abnormal heart rhythm.

Surgery or other procedures

To improve the heart’s function and relieve symptoms, several devices can be surgically implanted in the heart, including:

Implantable Cardioverter-Defibrillator (ICD). An ICD does not treat cardiomyopathy; rather, it watches for and regulates irregular rhythms, a significant complication of the illness. This device monitors heart rhythm and delivers electric shocks when necessary to control irregular heart rhythms.
Ventricular Assist Device (VAD). A VAD, which can be used as a long-term treatment or as a short-term treatment while awaiting a heart transplant, is typically considered after less invasive approaches are unsuccessful.
Pacemaker. To manage arrhythmias, a tiny device is inserted under the skin in the chest or belly.

The following surgical procedures are used to treat cardiomyopathy:

Septal myectomy. A portion of the wall of the thicker heart muscle that separates the two bottom heart chambers is removed during this open-heart procedure. The blood flow through the heart is improved, and mitral valve regurgitation is decreased, when a portion of the heart muscle is removed. Treatment for hypertrophic cardiomyopathy involves septal myectomy.
Heart transplant. Individuals with end-stage heart failure, for whom conventional treatments have proven ineffective, may require a heart transplant as a last resort.

Diseases & Conditions Cardiomyopathy