Facts About Cardiomyopathy in Adults

What Is Meant by Cardiomyopathy?

‘Cardio’ means heart, and ‘myo’ refers to muscle. So, the term cardiomyopathy describes a disease of the muscles of the heart. In this condition, there is difficulty in the heart’s chambers to pump blood effectively to all the body’s tissues. This difficulty might result in cardiac failure or cardiac arrhythmia in the long run. Also, valvular dysfunctions can occur as a result of cardiomyopathy. It can be either genetic or acquired. The muscles of the heart become thick and rigid and show enlargement in most cases. However, in a few, scar tissue replaces the diseased heart muscles.

How Prevalent Is Cardiomyopathy?

Cardiomyopathy is prevalent in about one in every 500 individuals, and it can occur in anyone. However, few types have some gender predisposition with arrhythmic and dilated cardiomyopathy common in males.

What Increases the Risk of Cardiomyopathy?

• Obesity.

• Increased alcohol consumption.

• Family history of heart diseases like cardiac arrest or cardiomyopathy.

• Previous cardiac problems like endocarditis, coronary artery disease, and heart attack.

• Drug abuse.

• A prolonged rise in blood pressure.

• Cancer chemotherapy and radiotherapy.

• Amyloidosis.

• Sarcoidosis.

• Diabetes.

• Thyroid disorders.

• Hemochromatosis.

What Are the Types of Cardiomyopathy?

Depending on how and which heart muscle is affected, there are a few types.

1. Hypertrophic: In this type, the heart muscles thicken, which results in ineffective functioning of the heart. The left ventricle, a critical chamber for pumping, is commonly affected. Also, it has been attributed that this type of cardiomyopathy has a genetic predisposition.

2. Dilated: The muscles get thin and stretched out in this type, causing the chamber to get enlarged. The left ventricle is the most commonly affected chamber. It is common in middle-aged males and can also be due to genetic defects.

3. Restrictive: The heart muscles become stiff and rigid, making it hard to expand and fill in blood. This type of cardiomyopathy is common in older adults, and it usually is idiopathic in nature. However, amyloidosis can also cause its occurence.

4. Arrhythmogenic: The muscles of the right ventricle are replaced by scar tissue which results in arrhythmic conditions. Genetic mutations are an important cause of this type of cardiomyopathy.

5. Transthyretin Amyloid Cardiomyopathy: Left ventricle shows an abnormal build-up of proteins.

6. Unclassified: This includes peripartum cardiomyopathy, alcoholic cardiomyopathy, ischemic cardiomyopathy, broken heart syndrome, and chemotherapy-induced cardiomyopathy.

What Are the Causes of Cardiomyopathy?

It may be caused due to varying reasons.

• Inheriting it from parents.

• Prolonged hypertension.

• Tissue damage after a heart attack.

• Prolonged tachycardia.

• Heart valve defects.

• Infections that affect the heart muscle.

• Metabolic disorders like thyroid dysfunction and diabetes.

• Tissue diseases such as amyloidosis, sarcoidosis, lupus, vasculitis, etc.

• Vitamin deficiency, in particular, Vitamin B1 (Thiamine).

• Obesity.

• Smoking.

• Hemochromatosis or the building up of iron in the heart.

• Drug abuse.

• Connective tissue disorders.

• Overconsumption of alcohol over a long time.

• Chemotherapy and radiotherapy.

• Sometimes as a complication of pregnancy.

What Are the Signs and Symptoms of Cardiomyopathy in Adults?

Initially, cardiomyopathy does not produce any symptoms, but as the disease progresses, it shows signs and symptoms. These symptoms worsen over time if left untreated. The person may experience one or many of the following.

1. Shortness of breath.

2. Lightheadedness and dizziness.

3. Extreme fatigue.

4. Chest pain.

5. Fainting.

6. Abdominal bloating.

7. Persistent cough while lying down.

8. Lying in a flat position becomes difficult.

9. Swelling of legs, feet, and ankle (edema).

10. Difficulty with focus and concentration.

11. Palpitations.

12. High blood pressure.

How Is Cardiomyopathy Diagnosed?

Few tests help with the diagnosis and classification into which type of cardiomyopathy it is.

1. Physical Examination- Physical examination along with complete family and medical history is done.

2. Blood Tests- Blood tests are done to determine iron levels and the function of the liver, kidney, and thyroid. B-type natriuretic peptide (BNP) is a protein that increases after heart failure. Therefore, a blood test to measure the level of BNP is helpful in determining heart failures.

3. Echocardiogram- It helps in identifying the cause of the symptoms. In this test, the image of the heart shows the motion and size of the heart while beating.

4. Chest X-Ray- It helps in diagnosing if the heart is enlarged or not.

5. Cardiac CT Scan- In a CT scan, a rotating X-ray tube takes pictures of your chest and heart to help in determining the heart size, valves, and functions of the heart.

6. Cardiac MRI- In a cardiac MRI, the image of your heart is obtained with the help of radio waves and magnetic waves. It is recommended in cases where an echocardiogram is not helpful in diagnosing cardiomyopathy.

7. Electrocardiogram- The electrocardiogram uses electrical signals to detect the areas of injuries in the heart and also to detect abnormal rhythms. It is a non-invasive test in which electrodes are placed on the skin of the chest to detect electric signals.

8. Radionuclide Ventriculogram- In this test, a radioactive substance is injected intravenously to measure the amount and blood flow of the heart while it is beating. It assesses the function of the heart.

9. Treadmill Stress Test- It is done to determine the exercise capacity and also to check for the presence of abnormal rhythms while exercising.

10. Cardiac Catheterization - During this test, the pressure within the heart vessels is determined with the help of a catheter which is inserted through the blood vessel to gain entry into the heart. It is also helpful in determining the blocks on the heart. In terms of the coronary angiogram, a dye is injected for better visualization with X-rays.

11. Genetic Testing- As cardiomyopathy runs in families, genetic testing for first-degree relatives might be advised in some.

What Is the Treatment of Cardiomyopathy?

It is essentially not treatable but controlled with the following.

• Lifestyle Changes.

• Medications- These help in improving the effective pumping of heart muscles, decrease blood pressure, prevent the formation of blood clots, enhance the blood flow, slow down heart rate, and also remove the extra fluid present in the body.

• Cardioversion or Ablation- It is of two types, namely radiofrequency ablation and septal ablation. In the radiofrequency ablation, electrodes are placed at the tip of catheters, which transmits energy and destroys the abnormal tissue causing the abnormal rhythm. In the case of septal ablation, alcohol is injected through the catheter to destroy the thickened heart muscle.

• Pacemakers, Ventricular Assist Device, and Implantable-Cardioverter Defibrillators- These are devices that are surgically implanted into the heart to aid in the functional improvement and also to relieve the symptoms caused.

• Surgery:

◦ Heart Transplant- When no other treatments and medications work, leading to end-stage heart failure, heart transplantation is recommended.

◦ Septal Myectomy- It is an open heart surgical procedure in which a part of the thickened heart muscle is removed to improve the function of the heart.

What Are the Complications of Cardiomyopathy?

• Cardiac arrhythmia.

• Heart failure.

• Formation of blood clots.

• Heart valve diseases.

How Can We Prevent Cardiomyopathy?

Make lifestyle changes as advised to prevent the disease from progressing.

1. Stop smoking.

2. Getting into the ideal weight range.

3. Quit using alcohol.

4. Avoid stress.

5. Eat healthily.

6. Get blood pressure under control.

7. Take medicines regularly as advised by your doctor.

For more information, consult a cardiomyopathy specialist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist/cardiomyopathy