Cardiomyopathy

What is cardiomyopathy?

Cardiomyopathy is a type of heart disease that prevents the heart and heart muscle from pumping blood around the body properly, which can lead to heart failure. There are five main types of cardiomyopathy. Some are inherited while others are the result of viral infections or heart attacks.

What types of cardiomyopathy are there?

There are five main types. These include:

Dilated cardiomyopathy

Dilated cardiomyopathy (DCM) affects the left ventricle or main pumping chamber, causing the left ventricle to enlarge and weaken.

Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is an enlarging of the heart muscle cells, causing the walls of the heart to become abnormally thick.

Arrhythmogenic right ventricular cardiomyopathy

Arrhythmogenic right ventricular cardiomyopathy is a disorder that mainly affects the right ventricle. It is characterised by fibro-fatty replacement of the ventricular walls and is often associated with ventricular arrhythmias and can cause sudden death

Restrictive cardiomyopathy

Restrictive cardiomyopathy affects the walls of the lower ventricles (or heart chambers) making them abnormally rigid and inflexible. This means the ventricles cannot expand as they fill with blood. It is the rarest form of cardiomyopathy.

Left ventricular non-compaction cardiomyopathy (LVNC)

Left ventricular non-compaction cardiomyopathy (LVNC) is a heart condition in which there is abnormal development of the walls of the left ventricle from early on in life. The failure of the heart muscle to “knit” properly during critical stages of chamber formation results in thickening of the walls and muscular ridges (known as trabeculations) which gives the ventricle a spongy look. LVNC can be caused by mutations in several different genes and can occur in isolation or in association with other cardiac abnormalities. People with this condition may go on to experience heart failure due to reduced heart muscle contraction, or stroke.

Takotsubo cardiomyopathy

Another type of cardiomyopathy is broken heart syndrome, also known as takotsubo cardiomyopathy, or stress cardiomyopathy. During times of extreme mental and physical stress, the body releases a sudden burst of adrenaline and stress hormones. This can cause the small arteries around the heart to constrict, which reduces the blood flow to the heart and stuns the heart muscle temporarily, causing symptoms that are similar to a heart attack.

What are the symptoms of cardiomyopathy?

The symptoms of cardiomyopathy can include:

• Breathlessness with exertion or at rest
• Swelling of the legs, ankles and feet
• Bloating or inflammation in the abdomen due to fluid build up
• Fatigue
• Irregular heartbeats that feel rapid, pounding or fluttering
• Chest pain
• Dizziness, light-headedness and fainting

It is important to detect and treat cardiomyopathy as early as possible, regardless of the severity of your symptoms. This may protect the heart from deteriorating rapidly.

What are the causes of cardiomyopathy?

There are many causes of cardiomyopathy but in some cases an underlying cause cannot be identified. Known causes can include;

• Genetic variants.
• Long-term high blood pressure
• Heart tissue damage from previous heart attack
• Certain infections which have injured the heart
• Prolonged rapid heart rate
• Heart valve problems
• Metabolic disorder including obesity, thyroid disease, diabetes
• Nutritional deficiencies
• Excessive alcohol consumption
• Drug use
• Hemochromatosis (an iron build-up in the heart muscle)
• Pregnancy complications
• Sarcoidosis (a condition causing inflammation and lumps of cell growth in the heart)
• Amyloidosis (a build-up of abnormal proteins)
• Connective tissue disorders

How is cardiomyopathy diagnosed?

To diagnose cardiomyopathy, your doctor will conduct a physical examination, discuss family medical history and review your symptoms. There are several tests patients undergo in order to confirm the diagnosis (and look for underlying causes or other disorders that may have a similar clinical presentation) which may include:

• Echocardiogram
• Electrocardiogram (ECG)
• Treadmill stress test
• Catheterization
• MRI
• CT scan
• Blood tests
• Genetic testing

How is cardiomyopathy treated?

Treatment plans depend on the severity and type of cardiomyopathy you have. The goals of a treatment plan are to manage symptoms, prevent the problem from worsening and reduce the risk of complications. More specific treatments include:

Dilated cardiomyopathy (DCM)

• Medications
• Surgically implanted devices

Hypertrophic cardiomyopathy

• Medications
• Implantable cardioverter-defibrillator (ICD)
• Septal myectomy (removing a portion of the septum that is obstructing the flow of blood from the to the aorta)
• Septal ablation (reduces the proportion of tissue blocking the blood flow due)

Restrictive cardiomyopathy

• Medication
• Treatment focuses on improving symptoms

If the less invasive approaches listed above are unsuccessful, your doctor may consider the following:

• Ventricular assist devices (VADs)
• Heart transplant

How can cardiomyopathy be prevented?

In many cases, cardiomyopathy is difficult to prevent, especially if you have a family history of the condition. To help reduce your chance of developing the heart disease you can:

• Avoid excessive alcohol
• Avoid drug use
• Manage high blood pressure, high cholesterol and diabetes
• Eat a healthy diet
• Eat less salt
• Exercise regularly - simply starting with daily walking
• Reduce stress levels
• Regular sleep

Cardiomyopathy patient stories

Read the stories of these amazing heart warriors who've experienced cardiomyopathy and complications in their heart disease battles.