What is cardiomyopathy?
Cardiomyopathy refers to diseases of the heart muscle. Patients with cardiomyopathy have an enlarged, thick or rigid heart muscle. This can cause the heart to weaken and become less able to pump blood and maintain a normal rhythm which, in turn, can lead to irregular heartbeats, heart failure or other problems. There are four main types of cardiomyopathy: hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy and arrhythmogenic right ventricular dysplasia.
Types of cardiomyopathy
Dilated Cardiomyopathy (DCM) In DCM, the heart muscle in one of the heart’s chambers, most often the left ventricle or main pumping chamber, begins to stretch and become thinner (dilate). This causes the inside of the chamber to enlarge. The problem often spreads to other chambers of the heart as the disease gets worse. When the heart chambers dilate, the heart muscle can’t contact normally and the heart can’t pump blood very well. Over time, the heart becomes weaker and heart failure can occur. DCM can also lead to heart valve problems, arrhythmias and blood clots in the heart. DCM occurs most often in people aged 20 to 60 and is more common in men than women.
Hypertrophic Cardiomyopathy (HCM) HCM is a relatively common cardiomyopathy. About 1 out of every 500 people has HCM. It affects people of any age and is found in men and women at the same rate. Most people with HCM have no symptoms, and the disease does not affect their lives at all. However, in some people HCM can cause severe symptoms and complications, such as shortness of breath and the inability to exercise. HCM occurs when heart muscle cells become disoriented, and enlarge to cause the walls of the left ventricle septum to thicken. The thickening may block blood flow out of the ventricle, or it may make the space inside the ventricle smaller so it holds less blood. The walls of the ventricle may also stiffen, making it less able to relax and fill with blood. These changes raise the blood pressure in the ventricles and the blood vessels of the lungs. Changes also occur to the cells in the damaged heart muscle. Cellular changes may disrupt the heart’s electrical signals and lead to arrhythmias.
Restrictive Cardiomyopathy This condition affects older adults most often. In restrictive cardiomyopathy, abnormal tissue replaces healthy heart muscle. The ventricles become stiff and rigid. As a result, they can’t relax normally and fill with blood, and the upper chambers of the heart (atria) become enlarged. Over time, blood flow in the heart is reduced. This can lead to problems such as heart failure and arrhythmias.
Arrhythmogenic Right Ventricular Dysplasia (ARVD) This is a rare type of cardiomyopathy. It occurs if the muscle tissue in the right ventricle dies and is replaced with scar tissue. This disrupts the heart’s electrical signals and causes arrhythmias. Symptoms may include palpitations and fainting after physical activity. ARVD usually affects teens and young adults. Like HCM, it can cause sudden cardiac arrest in young athletes.
What are the signs and symptoms?
Some people who have cardiomyopathy never have signs or symptoms. As cardiomyopathy worsens and the heart weakens, signs and symptoms of heart failure may occur. These include shortness of breath, trouble breathing with physical exertion, fatigue, and swelling in the abdomen and lower extremities. Other symptoms include dizziness and lightheadedness, fainting during physical activity, irregular heartbeats, chest pain or heart murmurs.
Methods of treatment
The specific treatment method employed will depend on the type of cardiomyopathy, the severity of symptoms and complications, and your age and overall health. The main goals of cardiomyopathy treatment are managing any contributing conditions, controlling symptoms for a normal lifestyle, stopping the progression of the disease, and reducing complications and the risk of SCA. Treatment methods include medication, surgical procedures and lifestyle changes.