Cardiomyopathy is a general term that refers to weakening of heart muscles. It occurs when there are other heart problems or when the heart does not pump in its normal way. When patients have cardiomyopathy, it may lead to heart failure when the heart does not pump sufficient blood to the body.
Types and Risk factors
There are 5 different types of cardiomyopathy:
- Dilated cardiomyopathy – the heart becomes enlarged and weak, does not pump blood and is caused due to various medical problems
- Hypertrophic cardiomyopathy – the heart muscles thicken, it makes it difficult for blood to exit the heart, it is hereditary
- Ischemic cardiomyopathy – the arteries supplying blood to the heart become narrow, it affects the elderly and is the most common form of cardiomyopathy
- Restrictive cardiomyopathy – heart muscle becomes stiff and hence heart chambers do not fill with the required quantity of blood
- Peripartum cardiomyopathy – happens during pregnancy or within 5 months after delivery
Common causes and risk factors of all these types of cardiomyopathy are:
- Cardiac Amyloidosis that results in abnormal protein called amyloid getting deposited in the heart tissue. This prevents the heart from functioning normally.
- Chemotherapy drugs taken to kill cancer cells
- Coronary heart disease, which is the common cause of ischemic cardiomyopathy, and causes the narrowing of arteries (due to plaque build-up) that supply vital oxygen and blood to the heart
- End-stage kidney disease or complete renal failure
- Genetic defects like muscular dystrophy
- Hypertension or high blood pressure
- Immune system diseases like Lyme disease, Chagas disease or HIV
- Deficiency in key nutrients like calcium, thiamine or selenium
- Pregnancy – cause of peripartum cardiomyopathy
- Systematic lupus erythematosus – a chronic autoimmune disorder that affects the joints, skin, brain, and other vital organs
Other risk factors of cardiomyopathy are:
- Alcoholism and smoking
- Heart rhythm problems such as atrial fibrillation
- Trace elements like arsenic, lead or mercury
- Tumors of the heart
- Carcinoid heart disease when small tumors are formed in the heart
- Excessive iron deposit in the body
- Sarcoidosis that causes inflammation of the lymph nodes
- Scleroderma – an autoimmune disease that destroys healthy tissues of the body
- Loeffler’s syndrome and endomyocardial fibrosis that affect the heart lining
Symptoms of Cardiomyopathy
It is important to identify the common cardiomyopathy symptoms and get immediate treatment.
- Feeling of breathlessness or shortness of breath, even with the smallest activity or sometimes even when resting
- Ankles, feet and legs become swollen
- Fluid retention is an important sign of cardiomyopathy. This takes place anywhere. Your abdomen starts to bloat due to fluid build-up. Similarly, fluid can collect in your feet, legs or ankles too. Fluid retention causes unnatural weight gain. Make sure you check your weight, especially if you have not changed your diet recently. Fluid retention in the lungs causes a wet sounding cough.
- Fatigue that is a feeling of tiredness and lethargy is a common symptom of cardiomyopathy. Patients suffer from lack of blood since the heart is not functioning properly. This causes fatigue, insomnia and stress. If you start to feel tired, when doing simple chores like cooking or taking a shower, and if you have no other illness, you must be careful and check with your doctor.
- Rapid, fluttering, palpitations or pounding heart beat that is irregular
- Frequent dizzy spells accompanied by fainting episodes and a feeling of lightheadedness
What to do?
All types of cardiomyopathy symptoms are similar and will get worse unless they are treated. Some people can experience these symptoms for a long period without them worsening. In others, the symptoms progress rapidly. Call emergency services if you suffer from severe breathing difficulty, chest pain or faint for more than a few minutes. Since cardiomyopathy can be inherited, other family members will also be examined.
Treatment of cardiomyopathy symptoms depends on the type of the disease that the patient has.
In hypertrophic cardiomyopathy, a physical examination of the heart with a stethoscope is done. This is followed by an echocardiography, electrocardiography (ECG) and a chest X-ray. The usual treatment is an invasive procedure called cardiac catheterization, to determine the need for a heart bypass or angioplasty. Genetic testing of family members is done for this type of cardiomyopathy. Around 4% of those affected by hypertrophic cardiomyopathy (especially young athletes) die each year.
For those with dilated cardiomyopathy, similar tests to hypertrohpic cardiomyopathy will be done and a coronary angiography if other tests prove inconclusive. ß-blockers are the normal treatment options and prognosis is very poor with 40-50% of patients dying suddenly.
For restrictive cardiomyopathy, apart from normal tests, MRI scans maybe done along with iron tests or liver biopsy to detect levels of iron in the body or a rectal biopsy to detect amyloidosis. There is usually no effective treatment for this disease as the diagnosis usually comes too late. Only supportive care and some symptomatic treatment maybe provided.
General treatment includes medications, wearing a pacemaker to slow heart rate and wearing a defibrillator, which helps prevent abnormal heart rhythms. All treatments will focus on improving blood flow to the weakened heart. Sometimes, heart transplant in severe cases will be suggested. There are artificial heart pumps available that can be implanted in the heart but few patients are able to undergo this advanced procedure.
Cardiomyopathy : Prevention and Precaution
The prognosis for cardiomyopathy depends on the type and cause of cardiomyopathy, how well the patient responds to treatment, severity of the symptoms and general health and lifestyle. When the patient does not change his or her lifestyle, does not take medicines properly or suffers from other infections, it can result in symptoms worsening and the patient going in for heart failure.
There are no preventive measures for inherited cardiomyopathy. However, several lifestyle changes help a patient manage cardiomyopathy symptoms. Quit all habits like smoking, excessive alcohol consumption and drugs that cause heart diseases. Lose excess weight and eat heart-healthy foods that are low in saturated fats. Eat lots of fruits and vegetable and make sure you get enough minerals and vitamins through either diet or supplements. Eat a diet that is low in salt. Exercise moderately under advisement of your doctor.
Those who know that there is a family history of cardiomyopathy can inform their doctor in advance, who can conduct periodic tests. Early detection can prevent cardiomyopathy symptoms from worsening. Controlling weight, blood pressure, cholesterol levels and exercising are all good ways to promote heart health and avoid heart failure.