Cardiomyopathy

General Illness Information

Medical Term: CARDIOMYOPATHY

Common Name: Not specified

Description: A structural or functional abnormality of the muscle of the heart, causing weakening of the heart muscle. Results in inability of heart to pump blood efficiently. There are 3 types of cardiomyopathy and are classified as dilated, hypertrophic or restrictive.

Causes: Many known diseases can cause cardiomyopathy, or it may have no identifiable cause. There are different causes for the 3 different types of cardiomyopathy and they are outlined below:

Dilated Congestive Cardiomyopathy

  • In this disorder, the ventricles (lower chambers of the heart) enlarge but are unable to pump enough blood to keep up with the body’s needs, resulting in heart failure.
  • In the United States, the most common cause of dilated congestive cardiomyopathy is widespread coronary artery disease.
  • Infection (myocarditis) caused by viruses (including HIV), bacteria, fungi, and other organisms.
  • Endocrine disorders such as diabetes mellitus and thyroid disorders
  • Drugs and toxins- such as alcohol, cocaine and antidepressants. Alcoholic cardiomyopathy may develop after about 10 years of heavy alcohol abuse
  • Rare causes- pregnancy and connective tissue diseases such as rheumatoid arthritis
  • Hypertrophic cardiomyopathy
  • This refers to a group of heart disorders in which the walls of the ventricles thicken. Causes are listed below:
  • Birth defect
  • Hormonal disorders such as Acromegaly (excessive growth hormone), Pheochromocytoma (a tumor that produces adrenaline)
  • Neurofibromatosis
  • Conditions in which there is increased work load on the heart such as high blood pressure and aortic valve stenosis
  • Restrictive cardiomyopathy
  • This condition is due to a group of disorders of the heart muscle in which the walls of the ventricles become stiff, not necessarily thickened, and resist normal filling with blood between heartbeats. As a result, the amount of blood pumped out is adequate at rest but not when the person is exercising. This is the least common type of cardiomopathy and the cause is usually unknown.
    Some of the causes are listed below:
  • Infiltration of the heart muscle due to – sarcoidosis, amyloidosis, hemochromatosis ( iron overload)
  • Wegener’s granulomatosis – Tumor invading the heart muscle.

Prevention:

Drink alcohol in moderation (less than 1 or 2 drinks a day). Eat a well-balanced diet. Avoid risk factors where possible. Do not smoke.

Signs & Symptoms

Depending on severity of cardiomyopathy, the following symptoms may occur:

  • Shortness of breath or exertion.
  • Easy fatiguability.
  • Rapid heartbeat.
  • Irregular heartbeat.
  • Leg swelling (ankle edema).
  • Liver enlargement.
  • Chest pain.
  • Risk Factors
  • Age over 60.
  • Obesity.
  • Smoking.
  • Alcoholism.
  • Family history of coronary artery disease or cardiomyopathy.
  • Use of certain drugs, such as alcohol, cocaine, antidepressants, antipsychotics and certain chemotherapy medications.
  • Diabetes mellitus.
  • High cholesterol levels.
  • Thyroid disease.

Diagnosis & Treatment

General Measures:

  • Cardiologist consultation.
  • Diagnostic methods may include electrocardiogram, echocardiogram, X-rays of the heart and lungs, cardiac catheterization, CT scan, MRI, blood tests, and other special tests (such as cardiac biopsy).
  • Treat underlying disorders.
  • Control heart failure.
  • Prevent complications
  • Report any marked weight change to the doctor. This may indicate excess fluid accumulation.
  • Monitor blood pressure daily.

Medications:

  • Ace Inhibitors, beta-blockers, calcium channel blockers and/or digitalis to improve heart function.
  • Diuretics to decrease fluid retention.
  • Anticoagulants (blood thinners) to prevent clotting – because pooling of blood in the swollen heart may allow clots to form.
  • Drugs to prevent abnormal heart rhythms.
  • Vitamins or potassium supplements (if the disorder is caused by a deficiency).
  • Nitrates and other medications may be prescribed.

Activity:

  • Resume normal activities gradually. There may be some limitations depending on severity of the disorder.
  • Resume sexual relations when you feel better and your symptoms are well controlled.
  • Appropriate rest, sleep and avoidance of stress is important.

Diet:

  • Low-salt diet, and in some cases a low-fat diet.
  • A weight loss diet may be recommended if you are overweight.
  • Stop drinking alcohol.

Possible Complications:

Congestive heart failure.

Prognosis:

If the underlying disorder can be corrected, cardiomyopathy may be controlled. If the underlying cause can’t be corrected, cardiomyopathy is incurable and eventually leads to heart failure. Dilated cardiomyopathy is the commonest reason for heart transplants.

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