Cardiomyopathy

A heart muscle disease that causes it to pump blood for the body quite hard is called cardiomyopathy. Without treatment, it may lead to heart failure and other life-threatening heart problems.

While there are multiple cardiomyopathy types, the primary ones include dilated, hypertrophic, and restrictive cardiomyopathy.

Generally, doctors prescribe medicines, implanted devices, and heart surgery for people with this heart disease. In severe cases, people may need a heart transplant. However, treatments are different among people with cardiomyopathy because it depends on multiple factors. These include the severity and cause of the condition, existing health problems, your age, and others.

Symptoms

While, generally, this condition does not cause any symptoms, some people may experience them when the disease advances. Check below for some symptoms:

• Shortness of breath
• Chest pain
• Fast or pounding heartbeats
• Swelling that usually occurs in the legs, ankles, feet, stomach area, and neck veins
• Cough
• Sleeping problems (insomnia)
• Extreme tiredness (fatigue)
• Dizziness
• Fainting

If you suspect you are experiencing cardiomyopathy symptoms, immediately contact your healthcare professional. Furthermore, this heart disease may run in families. That’s why doctors may recommend your family members to be checked.

Causes

In most cases, the exact cause of cardiomyopathy remains unknown. While some people develop it due to other health problems (acquired cardiomyopathy), some people may be born with cardiomyopathy. In such cases, it is called inherited cardiomyopathy and it occurs due to an abnormal gene that passes from biological parents to biological children during pregnancy.

Check below for additional causes of cardiomyopathy:

• Chronic (long-term) hypertension (high blood pressure)
• Heart damage caused by myocardial infarction
• Fast heart rate for long periods
• Heart valve problems
• COVID-19 infection
• Some infections (such as those that cause heart inflammation)
• Metabolic disorders (including thyroid disease, diabetes, or obesity)
• Lack of minerals or vitamins in the diet (including Thiamin, also called vitamin B-1)
• Pregnancy complications
• Hemochromatosis (a condition in which Iron builds up in the heart muscle)
• Sarcoidosis (a disease in which granulomas develop in the heart or lungs)
• The buildup of abnormal proteins in the organs (amyloidosis)
• Disorders of the connective tissues
• Misuse of alcoholic drinks and illegal drugs (such as cocaine, amphetamines, or anabolic steroids)
• Cancer treatments (including radiation therapy, chemotherapy, and others)

Cardiomyopathy Types

• Dilated Cardiomyopathy – This type of cardiomyopathy causes the left ventricle (in most cases) to grow larger. Therefore, the heart cannot pump blood properly for the body’s needs. While it may affect anyone, it usually occurs in older people (over 50 years old). In addition, males are more prone to developing dilated cardiomyopathy than females. The most common causes of dilated cardiomyopathy are coronary artery disease, heart attack, and inherited abnormal genes.
• Hypertrophic cardiomyopathy – In people with this condition, the heart muscle becomes thickened, which also makes the heart pump blood harder. In most cases, it affects the main pumping chamber of the heart (left ventricle). This condition may begin at any age but tends to worsen during childhood. Many people with this condition have a family history of cardiomyopathy.
• Restrictive cardiomyopathy – In those who experience this type of cardiomyopathy, the heart muscle becomes stiff and less flexible. Thus, the heat cannot expand to fill with blood during heartbeats. Commonly, it occurs in older people, but it may happen at any age. If physicians cannot identify the exact cause of restrictive cardiomyopathy, it is called idiopathic cardiomyopathy. The most common cause of this cardiomyopathy type is amyloidosis.
• Arrhythmogenic right ventricular cardiomyopathy (ARVC) – This rare cardiomyopathy type usually occurs between 10 and 50 years old. ARVC negatively affects the muscles in the lower right heart chamber (also known as the right ventricle). In most cases, ARVC happens due to abnormal genes that pass from biological parents to biological children. However, this type of cardiomyopathy may affect the left ventricle too.
• Unclassified cardiomyopathy – There are other types of cardiomyopathy in which physicians cannot identify the exact cause.

Risk Factors

There are multiple factors that may increase your risk of developing cardiomyopathy. Examples include:

• Family history of the disease or heart failure, sudden cardiac arrest, and other heart problems
• Chronic hypertension
• Diseases that negatively affect the heart (including heart infection, previous myocardial infarction, coronary artery disease, and others)
• Obesity
• Heavy alcohol drinking
• Illegal drug use (such as anabolic steroids, amphetamines, cocaine, and others)
• Cancer treatments (including chemotherapy, radiation therapy, and others)

However, there are certain health conditions that may also increase your risk of cardiomyopathy. Check some of them below:

• Connective tissue disorders
• Sarcoidosis (a condition in which small patches begin to grow on different body organs and tissues)
• Amyloidosis (protein buildup that happens in multiple body organs)
• Thyroid condition
• Diabetes
• Hemochromatosis (excessive iron levels in the body)

What Are The Potential Complications of Cardiomyopathy?

Those who suffer from this condition may experience some complications, especially without treatment. Check below for some examples:

• Heart failure (the heart is no longer available to pump blood for the body’s needs)
• Blood clots – This complication often happens when the heart cannot pump blood properly. Thus, a blood clot may enter the bloodstream and block blood flow to essential body organs, including the heart, brain, and others.
• Heart valve conditions – Cardiomyopathy may lead to an enlarged heart that causes a valve to not close or open properly. Thus, the blood may begin to leak backward in the valve.
• Cardiac arrest and sudden death – In some cases, people with this heart condition may experience these complications.

How to Prevent Cardiomyopathy?

However, people with a family history of cardiomyopathy cannot prevent this condition. You should inform your doctor that you have a family history of this condition.

There are some tips that may help you reduce the risk of cardiomyopathy. For example:

• Adopt a healthy diet full of fresh fruits and vegetables
• Regular exercise
• Manage your stress
• Practice healthy sleep (regular sleep cycles)
• Do not drink alcohol or use recreational drugs
• Treat existing chronic health conditions (such as hypertension, high cholesterol, or others)

Diagnosis

First, physicians will evaluate your medical and family history and may ask some questions about your symptoms. Thereafter, they may perform some tests and a physical examination to confirm the disease and exclude others that may cause similar symptoms. Check below for some tests:

• Blood tests – These tests help doctors check for abnormalities linked with cardiomyopathy. These include abnormal iron levels, thyroid, liver, and kidney function, and others.
• Chest X-ray – This test is used to get detailed pictures of the heart and lungs. It helps diagnose multiple conditions of previous organs.
• Echocardiogram – This test uses sound waves to make pictures of the beating heart. It also may show how the blood flows through the heart.
• Electrocardiogram (ECG or EKG) – This is a quick test in which doctors measure the electrical activity of the heart. This test may identify an abnormal heart rhythm.
• Exercise stress tests – This test involves monitoring the heart during physical activity. For people who cannot exercise, physicians usually give a specific medicine that increases the heart rate.
• Cardiac catheterization – This test involves a thin and flexible tube (catheter) that is inserted into a major blood vessel (usually in the groin) and then guided to the heart. It helps identify a narrowed or blocked blood vessel.
• Other imaging tests – These include CT (computerized tomography) or MRI (magnetic resonance imaging) scans. These tests also are used to get detailed images of the heart. However, these are not enough to confirm the condition.
• Genetic testing – This condition may pass through families (also known as inherited cardiomyopathy). Discuss with your healthcare professional for more details if you have a family history of cardiomyopathy.

Treatment

The treatment goal is to lessen the symptoms and reduce the risk of complications and worsening of the condition. However, physicians prescribe different treatments to people because it depends on multiple factors. These include the type and severity of the condition, overall health, your age and preferences, and others. Check below for some treatments usually recommended for people with cardiomyopathy:

Medicines

Medications used to treat cardiomyopathy help reduce blood pressure, slow heart rate, prevent blood clots, improve blood flow and the heart’s ability to pump blood, and others. Check below for the most common medications used in people with this heart condition:

• Beta-blockers (such as Metoprolol, Propranolol, Atenolol, and others)
• ACE inhibitors
• Calcium channel blockers (such as Verapamil and Diltiazem)
• Diuretics (to remove extra water from the body)
• Digoxin
• Other medications include antiarrhythmic medicines, anticoagulants (also known as blood thinners), Sacubitril/Valsartan, Ivabradine, and Mavacamten.

Therapies

Check below for some treatments that can be done without surgery:

• Septal ablation – This treatment option is usually recommended for people with hypertrophic cardiomyopathy. It involves a catheter (a thin tube) inserted into the affected area. It helps improve blood flow and restore heart function.
• Other ablation types – It involves one or more catheters inserted in a blood vessel that goes to the heart. These therapies use heat or cold energy to make small scars in the heart that help block irregular heartbeats and restore heart function.

Other Treatments

There are other options to treat cardiomyopathy. These include:

• VAD (ventricular assist device) – This is a specific device that helps pump blood from the lower chambers of the heart to the whole body. This treatment is also called a mechanical circulatory support device.
• Pacemaker – This is a device that helps control heartbeats, and it is placed in the chest.
• Cardiac resynchronization therapy (CRT) device – This device helps the heart work properly in people with dilated cardiomyopathy.
• Implantable cardioverter-defibrillator (ICD) – Sometimes, physicians recommend this device because it can prevent a life-threatening cardiomyopathy complication (sudden cardiac arrest). ICD sends small electrical impulses to the heart when it identifies irregular heart rhythms.
• Septal myectomy – This is an open-heart surgery in which surgeons remove the thickened heart muscle part (also called septum) and separate the ventricles (the lower heart’s chambers). This surgery is an effective option for people with mitral valve regurgitation.
• Heart transplant – This surgery is recommended for people with end-stage heart disease in which it no longer pumps blood for the body’s needs. It also may be used when the patient does not respond to medicines or therapies.

Frequently Asked Questions

What are the most common cardiomyopathy types?

These include:

• Dilated cardiomyopathy (also known as congestive cardiomyopathy and it is the most common type)
• Hypertrophic cardiomyopathy
• Restrictive cardiomyopathy

However, other types include stress cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy (ARVC), peripartum cardiomyopathy, and transthyretin amyloid cardiomyopathy.

What causes cardiomyopathy?

For example:

• Extreme stress
• Nutritional deficiencies
• Medicines
• Other diseases (including coronary artery disease, viral infections, and others)
• Unhealthy lifestyle habits (including smoking, heavy alcohol drinking, lack of physical exercise, and others)
• Inherited abnormal genes

Can cardiomyopathy be cured?

Unfortunately, there are no ways to cure the condition, but there are multiple treatments that may effectively restore the heart’s pumping function. If you have additional questions, ask your healthcare provider.