What is cardiomyopathy?
Cardiomyopathy (cardio-my-op-a-thee) means disease of the heart muscle. It affects the muscle of your heart and reduces its ability to pump blood to the rest of your body.
Cardiac ischemia is the most common form of cardiomyopathy. It occurs when an artery leading to your heart becomes narrowed or blocked for a short time and oxygen-rich blood cannot reach your heart. Ischemic cardiomyopathy is the loss or weakening of heart muscle tissue caused by ischemia (which causes chest pain called angina) or silent ischemia (which causes no pain). The ischemia usually results from coronary artery disease and heart attacks.
Dilated (congestive) cardiomyopathy
This is another common form of cardiomyopathy. It affects the chambers of the heart by weakening their walls. It may be caused by a viral infection of the heart muscle, excessive alcohol consumption, cocaine and abuse of antidepressant drugs. In rare cases, it may be caused by pregnancy (PPCM) or connective tissue disease such as rheumatoid arthritis. But in most cases, the cause is unknown.
Hypertrophic cardiomyopathy (HCM)
This causes a thickening of the heart's walls, which makes it harder for it to pump blood. The most common form of hypertrophic cardiomyopathy (also known as HCM) occurs when the wall between the bottom chambers of the heart (the septum) becomes enlarged and blocks the flow of blood. HCM is usually an inherited disease caused by gene mutations, but sometimes the cause is not clear.
Although it is not very common, HCM can lead to the development of abnormal heart rhythms, known as arrhythmias, which can then lead to sudden death in some people.
This condition restricts the heart from stretching properly, which limits the amount of blood that fills the heart's chambers. It is a rare type of cardiomyopathy.
ARVC or ARVD
Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) or Arrhythmogenic Right Ventricular Dysplasia (ARVD) is a rare type of cardiomyopathy. It is a leading cause of sudden cardiac death among young people, particularly young athletes. However, it can be present in people at any age and fitness level. The most common symptoms include palpitations, fainting, chest pain and a rapid, irregular heartbeat. In ARVC/D, the right ventricular muscle develops scar tissue, which interferes with the heart’s normal beating rhythm. This condition is often caused by genetic mutations. Consult a doctor if you experience any symptoms, especially if someone in your immediate family has been diagnosed with ARVC/D.
Some people have no signs or symptoms. The most common symptoms that do occur include:
- Heart palpitations
- Breathlessness upon exertion (caused by fluid building up in the lungs)
- Hypertrophic cardiomyopathy may cause dizziness, fainting, heart murmurs and chest pain
- Restrictive cardiomyopathy can cause swelling of the hands and feet
If you have one or more of these symptoms, see your doctor. Get immediate medical help if you experience chest pain, fainting or difficulty breathing.
Diagnosing cardiomyopathy may require several tests. Any of the following may be required to make a firm diagnosis.
- Blood tests
- Cardiac catheterization
- Chest X-ray
- Electrocardiogram (ECG)
- Transesophageal echocardiogram
- Exercise electrocardiogram (Stress test)
How is cardiomyopathy treated?
Your doctor may treat your cardiomyopathy by suggesting lifestyle changes, medications or surgery.
If properly treated and controlled, many people with cardiomyopathy require very few changes to their normal lifestyle. However, a diagnosis of cardiomyopathy may require the patient to make some adjustments to their lifestyle. For instance, certain sports or activities may be limited or prohibited. Your doctor could also advise you about fluid and salt intake restriction. It is important for the patient to discuss this matter with their cardiologist to determine how best to live a healthy, active lifestyle while minimizing the risk of further complications.
If the underlying cause of cardiomyopathy is known, it must be treated immediately with medications including:
Surgery may be an option depending on what type of cardiomyopathy you have. Talk to your doctor to find out more about whether surgery can improve your condition. For a small percentage of patients with very advanced cardiomyopathy, a heart transplant may be necessary.
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