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Heart Disease 

Cardiomyopathy 

Definition

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

  • Dilated cardiomyopathy affects the left ventricle or main pumping chamber, causing the left ventricle to enlarge and weaken.
  • Hypertrophic cardiomyopathy is an enlarging of the heart muscle cells, causing the walls of the heart to become abnormally thick.
  • 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 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. 

Symptoms

The symptoms of cardiomyopathy may 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 cardiomyopathies as early as possible, regardless of the severity of your symptoms. This may protect the heart from deteriorating rapidly. 

Causes

There are many causes of the various cardiomyopathies but in some cases an underlying cause cannot be identified.

  • Genetic variants. . These may cause cardiomyopathy or affect the susceptibility to cardiomyopathy.
  • 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

Diagnosis 

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

Treatment

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 

  • 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 left ventricle 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

Prevention

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
  • East a healthy diet
  • Eat less salt
  • Exercise Regularly
  • Reduce stress levels
  • Regular sleep

Research into Cardiomyopathy

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