Cardiomyopathy

Cardiomyopathy refers to heart problems when the heart can't work the way it's supposed to because of damage to the muscle. The damage can be caused in many ways - heart attacks, viral infections, alcoholism, severe hypertension - and according to the American Heart Association (AHA) sometimes you can't find a reason. (Read about "Heart Attack" "Alcoholism" "Hypertension: High Blood Pressure")

Types of cardiomyopathy

There are many types of cardiomyopathy. The National Heart, Lung and Blood Institute (NHLBI) lists the following:

• Ischemic - which refers to heart muscle damage that results from coronary artery disease (Read about "Coronary Heart Disease")
• Dilated - which occurs when disease-affected muscle fibers lead to enlargement, or dilation, of one or more chambers of the heart. (Read about "Enlarged Heart")
• Hypertrophic - which is a growth of the muscle fibers in the heart walls. It leads to a thickening of the walls.
• Restrictive - where the walls of the ventricles (which are the pumps of the heart) stiffen and lose the ability to move blood.

Ischemic cardiomyopathy

Ischemic cardiomyopathy is caused by blockages of the coronary arteries, as a result of coronary artery disease. Ischemia means the heart is not getting enough blood, and it enlarges in an effort to get more blood. NHLBI says ischemic cardiomyopathy is the most common type of cardiomyopathy in the United States. Risk factors include heart attack, smoking, high cholesterol, and diabetes. (Read about "Heart Attack" "Quit Smoking" "Cholesterol" "Diabetes") Ischemic cardiomyopathy is also a common cause of congestive heart failure. (Read about "Congestive Heart Failure")

Dilated cardiomyopathy

NHLBI says that dilated cardiomyopathy (DCM) is by far the most common type of non-ischemic cardiomyopathy. It can also be quite dangerous. The slower movement of blood through the heart can result in the formation of clots. If those clots break free they can travel to other parts of the body resulting in serious conditions such as pulmonary embolism, heart attacks and strokes. (Read about "Pulmonary Embolism" "Stroke")

NHLBI says that most of the time the exact cause of DCM is unknown. The medical term used is idiopathic, meaning unknown. The condition then is often referred to as IDC. There are some other causes that are known. Alcoholism is a known cause that usually begins after a decade or so of heavy alcohol consumption. (Read about "Alcoholism") DCM can also occur as a complication of pregnancy. It is called peripartum cardiomyopathy. It usually occurs in the third trimester or after childbirth. (Read about "Stages of Pregnancy" "Childbirth") Various viral infections (Read about "Microorganisms") are known to cause heart enlargement, as are some toxins, and occasionally genetics are traced as the cause.

Hypertrophic cardiomyopathy

Seventy percent of the time, hypertrophic cardiomyopathy has a genetic or hereditary link, with other members of the patient's family having the disease as well. The growth of the heart muscle is usually in the left ventricle - that's the one that pumps blood out to most of the body. It shrinks the size of the pumping chamber and doesn't let the muscle relax enough for the heart to fill with blood.

Restrictive cardiomyopathy

NHLBI calls restrictive cardiomyopathy very rare in the United States. It happens when the walls of the heart muscle stiffen, the heart is unable to relax and completely fill with blood. The heart then has to work harder to move more blood. It is usually the result of other diseases, according to AHA. Some of those other diseases according to NHLBI are:

• amyloidosis - which is when abnormal protein fibers collect in the heart muscle
• sarcoidosis - which is an inflammatory disease that causes small lumps
• hemochromatosis or too much iron (Read about "Hemochromatosis")

NHLBI says that restrictive cardiomyopathy does not appear to have a genetic link.

Symptoms

Most of the symptoms for cardiomyopathy are the result of the heart's lessening ability to move blood around the body. The National Institutes of Health (NIH) list the following:

• lessening ability to exercise or tolerate physical exertion such as climbing stairs
• shortness of breath
• lightheadedness or fainting (Read about "Syncope/Fainting")
• chest pains (Read about "Angina")
• palpitations
• high blood pressure (Read about "Hypertension: High Blood Pressure")
• swelling of the extremities or other portions of the body indicating fluid retention
• irregular heart beat

Sometimes the first sign of cardiomyopathy is sudden death - which is why it's essential that you consult your doctor if you have any of the signs listed above. (Read about "Cardiac Arrest")

Treatments

Treatments vary depending on the type of cardiomyopathy, the extent of damage and the general health of the patient. Lifestyle changes are almost always called for, things such as alcohol consumption changes, smoking cessation, weight loss, and dietary changes including salt restrictions. (Read about "Sodium" "Quit Smoking" "Losing Weight")

A number of drug therapies are also often used. NIH and NHLBI list these drugs as possibilities:

• diuretics to help reduce the fluids in the body
• vasodilators to relax the blood vessels and make it easier for the heart to pump
• calcium or beta blockers to regulate heart beat

An internal defibrillator can be used to shock the heart back into normal rhythm. For patients with severe blood-flow obstruction whose symptoms don't respond to medications, a surgical procedure, called myectomy, can be used. This procedure removes a portion of the thickened muscle wall and can provide symptom relief. Transplantation is a treatment of last resort. (Read about "Transplants") Cardiomyopathy is the number one reason for heart transplants. NHLBI estimates that about 2,000 people have transplants each year - a fraction of the 50,000 affected.

Related Information:

    Cardiovascular Tests

    Coronary Heart Disease

    Arteriosclerosis & Atherosclerosis

    Congestive Heart Failure

    The Heart and Its Valves

    Glossary of Heart Terms