Cardiomyopathy

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By Ali

Definition
Cardiomyopathy is a group of diseases that weaken the heart muscle the
myocardium making it harder for the heart to pump blood cardiomyopathy
reduces the blood output and may lead to heart failure
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Etiology
The condition may be inherited from a parent

Or

develop as a consequence of another disease or factor

Some factors include

● Alcohol consumption
● A poor diet
● Cocaine intake
● Exposure to radiation
● High blood pressure
● Cholesterol
● Stress
● Smoking
● Obesity

Symptoms
● some patients do not experience any symptoms
● shortness of breath
● fatigue
● rapid heartbeats
● chest pain
● swelling of lower limbs
● dizziness and fainting

Progression of the disease varies greatly from person to person in some people
symptoms may appear suddenly and worsen quickly while others see a gradual
development over a long period of time
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Types of Cardiomyopathies
There are three major types of cardiomyopathy

1.Hypertrophic Cardiomyopathy or HCM

Hypertrophic cardiomyopathy or HCM is the thickening of the heart muscle most commonly
this occurs in the interventricular septum facing the left ventricle the thickened septum
obstructs blood flow to the aorta a condition called outflow tract obstruction or obstructive
hypertrophic cardiomyopathy thickening elsewhere in the heart muscle causes non- obstructive
HCM in both cases cardiac output is reduced while HCM can develop as a result of high blood
pressure or aging it is most commonly inherited as an Autosomal dominant trait children of an
affected parent have a 50% chance of inheriting the disease multiple mutations have been
identified in genes encoding for proteins of the heart muscle genetic screening is recommended
as the disease may progress rapidly from asymptomatic to heart failure and cardiac arrest in fact
HCM is the major cause of sudden cardiac death among young athletes people who test positive
for HCM are advised to avoid high intensity activities
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2. Dilated Cardiomyopathy DCM

Dilated cardiomyopathy DCM is the thinning of the myocardium and enlargement of a heart
chamber most commonly the left ventricle DCM is usually acquired and the cause is unknown
in most cases risk factors include high blood pressure damage to the myocardium caused by
previous heart attacks alcohol or cocaine use toxins or infections and obesity or diabetes while
DCM may develop in anyone at any age it is more common in men of middle age some DCM
cases are inherited
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3. Restrictive Cardiomyopathy RCM

Restrictive cardiomyopathy RCM is when the heart muscle becomes rigid lacking the elastic city
required to properly fill an pump blood RCM usually results from building up of scar tissues or
abnormal proteins caused by a variety of conditions RCM is more likely in older people less
common types of cardiomyopathy include a rhythm genic right ventricular dysplasia a
condition in which the right ventricle tissue is scarred causing a arrhythmias

Diagnosis
Some of the following tests may be employed to diagnose cardiomyopathy

Blood tests: With a needle, a tiny amount of blood is usually collected from a vein in your arm.

Chest X-ray: A chest X-ray photographs the organs and structures within your chest and can
reveal whether your heart is enlarged.
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EKG or ECG stands for electrocardiogram. An ECG records the electrical activity of the heart,
indicating how rapidly it is beating and if its rhythm is stable or erratic. Cardiomyopathy, as
well as other disorders such as heart attacks, arrhythmias (abnormal heartbeats), and heart
failure, can be detected with an ECG. You may need to use a portable ECG monitor to diagnose
intermittent cardiac issues.

Holter and event monitors are both portable devices that record the electrical activity of your
heart during regular daily activities. A Holter monitor captures the electrical activity of the
heart for 24 or 48 hours. An event monitor merely records the electrical activity of your heart at
specific periods.

An echocardiogram (Echo) is a test that employs sound waves to create a moving image of your
heart. It demonstrates how well your heart is functioning and its size and shape. "Stress echo,"
which is done as part of a stress test, is one sort of echocardiogram. Transesophageal
echocardiography (or TEE) provides a picture of the back of the heart.

Stress test: A stress test aims to make your heart work hard (and beat quickly) while tests are
being performed. Nuclear cardiac scanning, echocardiography, and positron emission
tomography (PET) scanning are examples of these tests. On an inclined treadmill, you will be
instructed to walk in place. If you are unable to exercise, you may be given a medication that
mimics the effects of exercise.

Treatment
Medications: Heart medications can improve your blood flow, manage symptoms or treat
underlying conditions. You may take blood thinners, beta-blockers l or medications to lower
cholesterol. This helps by reducing the amount of work your heart has to do

Devices to correct arrhythmias: Pacemakers or implantable cardioverter defibrillators treat

irregular heart rhythms. These devices monitor your heartbeat. They send electrical impulses to
your heart when an arrhythmia(abnormal heart rhythm) starts.

Devices to improve blood flow: Some devices help your heart pump blood more efficiently.
Cardiac resynchronization therapy (CRT) devices control the contractions between the left and
right sides of the heart. A left ventricular assist device (LVAD) helps your heart pump blood.
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Surgery: An open-heart surgery or a heart transplant is performed when all other treatments
have failed to bring relief.

Alcohol septal ablation (nonsurgical procedure): Ethanol (a type of alcohol) is injected through
a tube into the small artery that supplies blood to the area of heart muscle thickened by
hypertrophic cardiomyopathy. The alcohol causes these cells to die. The thickened tissue
shrinks to a more normal size.

Septal myectomy: This open-heart surgery is considered for people who have obstructive
hypertrophic cardiomyopathy and severe symptoms. A surgeon removes part of the thickened
septum that’s bulging into the left ventricle. This improves blood flow within the heart and out
to the body.

Management/Prevention

Cardiomyopathy can’t be stopped as it is inherited and can show up unexpectedly but

Cardiomyopathy can be prevented by an underlying disease or condition. Treating that initial
problem early enough may help prevent the complications presented by cardiomyopathy.