Cardiomyopathy

What is cardiomyopathy?

Cardiomyopathy is a disease of the heart muscle. The heart muscle gets bigger, thick, or stiff. This can weaken the heart and make it hard for the heart to pump blood.

There are 3 main types of cardiomyopathy:

• Dilated cardiomyopathy. The heart muscle gets weak. As the heart muscle weakens, it is less able to pump enough blood to the body. Because the heart can't pump as well, the main pumping chamber of the heart (the left ventricle) fills with blood and cannot empty. The extra blood in the left ventricle causes the heart muscle to stretch, just like a balloon expands when you put air into it. The heart slowly gets bigger over several weeks to months.
• Hypertrophic cardiomyopathy (HCM). The heart muscle cells get bigger. This makes the walls of the heart muscle thick. Thick walls are usually very stiff, making it hard for the heart to pump well.
• Restrictive cardiomyopathy. The heart muscle gets very stiff. The stiffness makes it hard for the heart to fill with blood and pump properly.

How does it occur?

The heart muscle may be weakened by many things, such as:

• coronary artery disease (CAD)
• untreated high blood pressure
• chronic illness, such as diabetes or thyroid disease
• a genetic problem inherited from your parents
• cocaine or heavy alcohol use
• infection, especially by a virus
• some cancer treatments

Often what causes the heart to get bigger and weaker is not known.

What are the symptoms?

Cardiomyopathy may not cause symptoms. If it does, some possible symptoms are:

• chest pain, especially after physical activity or heavy meals
• shortness of breath
• swelling of the legs or ankles
• tiredness
• dizziness
• fainting during physical activity.

How is it diagnosed?

Your healthcare provider will ask about your symptoms, examine you, and listen to your heart. You may have:

• chest X-rays
• electrocardiogram (ECG), which is a recording of your heart's electrical activity
• echocardiogram (an ultrasound scan of the heart), which can show areas of heart muscle that are thick
• coronary angiogram, which is an X-ray test that helps find blockages in the arteries that bring blood to the heart.

You may also need to wear a Holter monitor. A Holter monitor is used to record your heart rhythm for at least 24 hours.

Your provider may suggest testing other members of your family if he or she thinks that you may have an inherited form of cardiomyopathy.

How is it treated?

Treatment depends on the type of cardiomyopathy you have and what caused it. Medicines that may be prescribed include:

• Beta blocker or calcium channel blocker to relax the heart muscle. This helps lower blood pressure and heart rate so that the heart does not have to work as hard.
• Vasodilator to open up the blood vessels and let more blood flow through. This helps lower blood pressure so the heart does not have to work as hard.
• ACE inhibitors to relax blood vessels and lower blood pressure. This helps the heart to pump more blood out to the body.
• Diuretic (water pill) to help your body get rid of the extra fluid that can build up when the heart does not pump well.
• Blood thinner (anticoagulant) to help keep the blood from clotting and prevent artery blockages and strokes.

Procedures that may be used to treat cardiomyopathy include:

• Removal of a piece of heart muscle (a procedure called myectomy) with a heart catheter or surgery
• Insertion of an artificial pacemaker or an implantable cardioverter-defibrillator (ICD) to treat abnormal heart rhythms.

How long will the effects last?

The effects of cardiomyopathy depend on what has caused it. If it is caused by coronary artery disease, you are likely to have a weakened heart muscle for the rest of your life, but medicine may help the heart muscle function better. Other types of cardiomyopathy may get better over weeks to months, depending on the cause.

How can I help take care of myself?

• Take your medicines regularly, carefully following your healthcare provider’s instructions.
• Weigh yourself regularly and let your provider know if you suddenly gain weight.
• Avoid salty foods and eat a healthy diet with lots of fruits and vegetables.
• Ask your provider how much you can exercise and try to remain active. For some types of cardiomyopathy certain sports or activities are not recommended. You should ask your provider about activities such as scuba diving or competitive sports.
• Ask your provider how much fluid you should drink every day.
• Call your provider if you have changes such as shortness of breath, lightheadedness, or chest pain.

How can I help prevent cardiomyopathy?

• Life a healthy lifestyle with regular exercise and a healthy diet (high in fruits and vegetables).
• Do not smoke.
• Follow your healthcare provider’s recommendations. If you have high cholesterol or hypertension, take the medicines that have been prescribed for you to treat these conditions.