Cardiomyopathy is a disease caused by abnormalities in the heart muscle (myocardium), which makes it unable to pump blood to the body normally. Cardiomyopathy is divided into several types and can be caused by many things, including genetics, coronary artery disease, or taking certain medications.
Cardiomyopathy patients without symptoms may not need treatment. Patients with mild symptoms can adjust their behavior or take medication to control their symptoms. However, patients with severe symptoms need continuous treatment, such as taking medication, inserting devices to help the heart work, or may need surgery if the symptoms are very severe. This is to prevent serious complications such as arrhythmias, leaky atrial valves, or other complications.
Symptoms of Cardiomyopathy
In the early stages, there are usually no symptoms, but as time goes by, patients may develop the following noticeable symptoms:
- Feeling exhausted and tired
- Shortness of breath, especially during exercise or strenuous activity, but can also occur while resting.
- Dizziness, faintness, or fainting
- Chest pain and coughing while lying down
- Rapid or irregular heartbeat
- Abdominal swelling due to fluid accumulation in the abdominal cavity
- Swollen legs, ankles and feet
- High blood pressure
If any unusual symptoms or signs of Cardiomyopathy occur, patients should see a doctor, as leaving the abnormal symptoms untreated can make the symptoms worse. They should also inform their doctor if there is a family history of this disease. However, patients should see a doctor immediately if they experience severe shortness of breath, chest pain, or fainting.
Causes of Cardiomyopathy
The exact cause of cardiomyopathy is unknown, but it may be genetic or a result of an underlying disease. Cardiomyopathy can be divided into four main types:
Dilated Cardiomyopathy
Enlarged heart is often found in people aged 20-60 years. It is the most common type of cardiomyopathy. It occurs when the left ventricle muscle expands and the heart wall thins. This makes it unable to pump blood to the body normally and may be at risk of heart attack. Enlarged heart can be caused by many things, such as coronary artery disease, ischemic heart disease, drinking a lot of alcohol for a long time, or genetics.
Hypertrophic Cardiomyopathy
It is a condition in which the left ventricle of the heart muscle is abnormally thickened, causing blockage of blood flow. It is a condition that is thought to be caused by genetics. Generally, there may be no symptoms that affect the patient’s daily life. However, in some cases, it may cause other abnormalities, such as atrial fibrillation, mitral regurgitation, and a risk of endocarditis.
Restrictive cardiomyopathy
It is a rare condition that occurs when the heart muscle becomes stiff and inflexible, causing abnormal blood flow into the heart chambers as the heart relaxes. It can occur in people of all ages, but is more common in older adults. The exact cause of this condition is unknown, but it may be caused by certain diseases, such as hemochromatosis , amyloidosis, scleroderma, and sarcoidosis.
Arrhythmogenic Right Ventricular Dysplasia
It is a condition in which the right ventricle muscle cells die, causing fat and scar tissue to replace them, which can interfere with the electrical activity of the heart, leading to arrhythmias or sudden cardiac arrest . The cause may be a genetic abnormality or excessive exercise.
Other causes
Cardiomyopathy can also occur due to other causes, including:
- Chronic diseases such as obesity, diabetes, high blood pressure, or other heart diseases
- Family history of Cardiomyopathy, Heart Failure or Sudden Cardiac Arrest
- Drinking alcohol or using drugs
- Receiving chemotherapy or radiation to treat cancer
- Pregnancy
- Deficiency of certain vitamins and minerals, such as thiamine (Vitamin B1).
Diagnosis of Cardiomyopathy
The doctor will ask about the patient’s symptoms, medical history, or family members who may have had heart disease, which is a risk factor for developing Cardiomyopathy, as well as perform a preliminary physical examination and may conduct additional tests as follows:
- Chest X-ray to examine internal organs and detect possible enlargement of the heart.
- An echocardiogramis a procedure that uses sound waves to create an image of the heart to detect abnormalities in the heart, such as size, heart rhythm, and heart valves.
- An electrocardiogram (ECG/EKG) is a test that records the electrical signals from each heartbeat. It is recorded on an electrocardiograph, allowing the doctor to check the heart’s function or the area of injury.
- Exercise stress test: The doctor will have the patient walk on a treadmill and then check for blood pressure and abnormal heart rhythms.
- Cardiac catheterization involves inserting a small catheter through a vein in your leg or neck. The catheter is passed into your heart and a special instrument is used to cut a sample of heart muscle tissue to send to a laboratory for testing to diagnose how well your heart is pumping.
- Blood tests to measure liver, kidney, thyroid function and iron levels in the blood.
- Magnetic resonance imaging (MRI) scans provide images of the structure of the heart. They may be used in conjunction with an echocardiogram to provide a clearer diagnosis of abnormalities.
- A CT scan uses a computerized tomography (CT) machine to create images of the functioning and structure of the heart.
- Genetic Testing: Since Cardiomyopathy can be inherited.
Cardiomyopathy Treatment
The goal of treating Cardiomyopathy is to prevent symptoms from getting worse and reduce the chance of complications. Treatment options vary depending on the symptoms and severity, as follows:
Behavior Modification
Patients with mild symptoms may not require treatment, but lifestyle changes may help improve symptoms and may reduce the chance of recurrence later in life.
- Keep your weight within the standard range and exercise regularly.
- Eat a healthy diet, avoid foods high in saturated fat, sodium and sugar, and avoid caffeinated beverages.
- Get enough sleep
- Relieve stress in the right way
- Avoid smoking and drinking alcohol.
Drug treatment
Doctors may prescribe medications that help the heart function and blood flow, including antihypertensives, medications that help control or normalize the heart rate, antiplatelet drugs, diuretics, and aldosterone blockers to maintain the body’s mineral balance. However, if the patient has a chronic disease such as diabetes or high blood pressure, they should take the medication strictly as prescribed by the doctor.
Non-surgical treatment
Non-surgical treatment of Cardiomyopathy may include the following:
- Septal ablation is a procedure that thins the abnormally thickened portion of the heart muscle, which improves blood flow from the heart chambers to the blood vessels.
- Radiofrequency Ablation (RF Ablation) involves inserting a catheter into the heart through a blood vessel and delivering radiofrequency energy to treat abnormal heart rhythms.
Surgical treatment
The surgical procedure used to treat Cardiomyopathy is open surgery to remove the abnormally thickened heart muscle, which improves blood flow from the heart and reduces the risk of heart valve leakage.
In addition, doctors may surgically insert devices near the heart to help treat symptoms and improve heart function, including implantable cardioverter defibrillators, ventricular assist devices, and pacemakers.
Complications of Cardiomyopathy
Cardiomyopathy may cause the following complications:
- A heart attackoccurs when the heart muscle is unable to pump enough blood to the body. If left untreated, it can be life-threatening.
- Blood clots When the heart can’t pump blood, a blood clot can form in the heart. If the clot enters the bloodstream, it can block blood flow to the brain and heart.
- Heart valve leakage: If the heart enlarges, the heart valve may not close properly, allowing blood to flow backward.
- Cardiomyopathy can cause arrhythmias, which can cause the patient to faint and, if the heart stops beating, can cause the patient to die.
Cardiomyopathy Prevention
Although genetic causes cannot be prevented, you may be able to reduce your risk of developing cardiomyopathy from other causes, such as coronary artery disease, diabetes, high blood pressure, and heart attack that can lead to cardiomyopathy, by taking the following steps:
- Eat healthy foods and avoid foods high in fat and sodium.
- Avoid drinking caffeinated beverages.
- Exercise regularly
- Get enough rest and find appropriate ways to de-stress.
- If you have a chronic disease such as diabetes or high blood pressure, you should see a doctor as scheduled, take care of your health, and take your medication as prescribed by your doctor.
