Conditions

Cardiomyopathy

Cardiomyopathy is a medical condition that affects the heart muscle, leading to abnormal heart beats. It can be a life-threatening disease and in severe cases may require a heart transplant. Cardiomyopathy can be caused by various factors, including diseases of the heart muscle.

• Dilated cardiomyopathy is characterized by the enlargement of the heart chambers and a decrease in the heart’s ability to pump blood effectively. It may result from genetic factors, infections or exposures to toxins. Over time, a type of scarring can form in the heart, further impairing its function.
• Hypertrophic cardiomyopathy involves the thickening of the heart muscle, particularly the left ventricle. This condition can obstruct blood flow from the left ventricle to the aorta and the rest of the body. In some cases, the symptoms can require implantable devices like pacemakers or defibrillators to manage irregular heartbeats.
• Takotsubo cardiomyopathy, sometimes referred to as “broken heart syndrome,” is a type of cardiomyopathy triggered by severe emotional or physical stress. It can cause sudden chest pain and shortness of breath, mimicking a heart attack.

This condition can sometimes be caused or worsened by coronary artery disease. Heart valve disease can also cause cardiomyopathy, particularly when the tricuspid valve or the mitral valve malfunction. The mitral valve is responsible for regulating blood flow between the left atrium and the left ventricle.

Cardiomyopathy can lead to serious complications including heart failure, sudden cardiac arrest, arrhythmia and heart valve issues.

Risk Factors

People of all ages and backgrounds can experience cardiomyopathy, however certain forms of the disease can be more prevalent in certain groups. For example, dilated cardiomyopathy is more common in African Americans than Whites and more common in men than women according to the Centers for Disease Control and Prevention.

Heart valve problems can contribute to cardiomyopathy. The heart valves play an important role in ensuring proper blood flow through the heart, delivering oxygen and nutrients to the body. Abnormalities or malfunctions in the heart valves can affect heart function and lead to complications like heart failure.

Additional major risk factors for cardiomyopathy include:

• A family history of cardiomyopathy, heart failure or sudden cardiac arrest
• A disease or condition that can lead to cardiomyopathy, such as ischemic heart disease, heart attack or a viral infection that inflames the heart muscle
• Diabetes
• Severe obesity
• Diseases that can damage the heart, such as hemochromatosis, sarcoidosis or amyloidosis
• Alcoholism
• High blood pressure

Symptoms of Cardiomyopathy

People with cardiomyopathy may experience many symptoms including fatigue, swelling in the extremities and chest pain. This condition does not directly affect the surrounding skin but patients may notice side effects like swelling in the legs and ankles caused by fluid retention due to heart failure.

Shortness of breath may occur because the heart’s pumping ability is compromised, reducing the blood flow to the pulmonary artery.

Sudden cardiac death can be a tragic consequence of certain types of cardiomyopathy.

Detection and Diagnosis

Cardiomyopathy is diagnosed using a variety of tests. These can include cardiac catheterization, echocardiography, stress testing and more. Your doctor may want to know about your medical history including family history and what symptoms you have and for how long you have been experiencing them. Additionally, your doctor may perform a physical examination and further diagnostic testing for an accurate diagnosis.

• Medical history: Your doctor will ask about your medical history, current symptoms, and relevant risk factors or medical conditions. They will also ask about family history of heart disease, sudden cardiac death or cardiomyopathy.
• Physical exam: During this exam, the doctor will listen to your heart and lungs, check your blood pressure and look for signs of heart failure, such as swelling in the legs or ankles.
• Electrocardiogram: This test creates images of the heart to assess its structure and function. It reveals abnormalities in the heart’s size, shape and pumping ability.
• Holter monitor: These devices continuously monitor the heart’s electrical activity over an extended period of time. This can help show irregular heart rhythms that might not show up during an electrocardiogram.
• Cardiac MRI or CT: These scans provide detailed images of the heart that can be used to see subtle changes in the heart muscle’s structure, blood flow and function.

Cardiomyopathy Treatments

Sometimes, cardiomyopathy may come and go on its own, without the need for treatment. However, more severe cases may require attention to make the heart pump correctly. 

Lifestyle changes like increased physical activity and medication like beta blockers can help manage cardiomyopathy. Other treatments include pacemakers and implantable devices, surgery and nonsurgical procedures. In some cases, surgery may be necessary to repair or replace damaged heart valves or remove hypertrophic scar tissue.