Heart Muscle Disease Cardiomyopathy

What is cardiomyopathy?

Cardiomyopathy is a disease of the heart muscle. There are three main types:

• Hypertrophic cardiomyopathy: Abnormal thickening of the heart muscle
• Restrictive cardiomyopathy: Happens when the heart is stiff and/or scarred
• Dilated cardiomyopathy: When the left ventricle of the heart becomes abnormally enlarged and weakened

When the heart is damaged, it becomes very difficult for it to efficiently pump blood to the body. Without the right treatment and care, cardiomyopathy can lead to heart failure and the possible need for a heart transplant.

What are the causes of cardiomyopathy?

In many cases of cardiomyopathy, the exact cause is unknown. Some cases occur, while others are inherited. Causes include:

• Connective tissue disorders
• Pregnancy complications
• Infections that inflame the heart
• Amyloidosis (build-up of proteins in the heart and other organs that replace the normal muscle)
• Sarcoidosis (a condition whereby lumps of inflammatory cells begin to grow in the heart and other vital organs, damaging the heart, and increasing the risk of cardiomyopathy)

What are the symptoms of cardiomyopathy?

As with many cardiovascular diseases, there may be no signs or symptoms of cardiomyopathy until the condition progresses. When they appear, they typically include:

• Shortness of breath
• Rapid, fluttering, or pounding heartbeat
• Swelling in the legs, ankles, and feet
• Chest pressure and discomfort
• Fatigue
• Cough while lying down
• Abdominal bloating due to fluid build-up
• Dizziness and fainting

Symptoms generally get worse if left untreated. In some cases, cardiomyopathy takes years to worsen, while in others, it progresses very quickly.

What are the risk factors of cardiomyopathy?

• Genetics/Family history
• Long-term high blood pressure
• Use of cocaine or amphetamines
• Hemochromatosis (build-up of excess iron within the heart muscle)
• Excessive use of alcohol
• Prior heart attack and/or heart tissue damage
• Obesity
• Diabetes

How is cardiomyopathy diagnosed?

• Physical examination
• Medical history
• Chest X-ray
• Echocardiogram
• Electrocardiogram (ECG)
• Treadmill stress test
• Cardiac catheterization
• Cardiac magnetic resonance imaging (MRI)
• Cardiac computed tomography (CT) scan
• Blood tests including kidney, thyroid and liver function tests, and iron and B-type natriuretic peptide (BNP) measurements
• Genetic testing or screening

What are the treatment options for cardiomyopathy?

• Medications to help improve the heart's ability to pump blood, improve blood flow and reduce blood pressure
• Nonsurgical procedures including septal ablation and radiofrequency ablation
• Surgery or other procedures, including:
  1. Surgically implanted devices e.g., implantable cardioverter-defibrillator (ICD), ventricular assist device (VAD) and pacemaker
  2. Surgeries e.g., septal myectomy and heart transplant

What are the prevention tips for cardiomyopathy?

Lower your risk of cardiomyopathy by living a heart-healthy lifestyle such as:

• Refraining from consuming alcohol or cocaine
• Controlling your blood pressure, cholesterol, and sugar levels
• Consuming a healthy diet
• Exercising on a regular basis
• Getting adequate sleep and rest
• Lowering your stress level

References

1. Cardiomyopathy. Available at https://www.cdc.gov/heartdisease/cardiomyopathy.htm [Accessed on 9 May 2022]
2. Cardiomyopathy. Available at https://www.mayoclinic.org/diseases-conditions/cardiomyopathy/symptoms-causes/syc-20370709?p=1 [Accessed on 9 May 2022]
3. Cardiomyopathy- Diagnosis. Available at https://www.mayoclinic.org/diseases-conditions/cardiomyopathy/diagnosis-treatment/drc-20370714?p=1 [Accessed on 11 May 2022]