Monday 19 October 2015

Cardiomyopathy

The muscles of the heart have the most important function in the body. They help the heart to pump blood, throughout the body. When these muscles become abnormal, they affect the functioning of the heart and its ability to pump blood, to maintain its regular rhythm. 

Any condition that affects the functioning of the muscles of the heart is known as Cardiomyopathy. There are different types of cardiomyopathy disorders:
  • Hypertrophic
  • Dilated
  • Restrictive or Idiopathic
  • Arrhythmogenic right ventricular dysplasia
  • Unclassified Cardiomyopathy
  • Stress induced Cardiomyopathy or Broken Heart Syndrome or Takotsubo cardiomyopathy (tako tsubo refers to the pot-like shape of the heart that resembles octopus traps)
In a Cardiomyopathy patient, progressively, the heart muscles enlarge, become thicker or rigid. In very rare cases, scar tissue replaces the muscle tissue of the heart.

The end result of Cardiomyopathy is that it can lead to heart failure.

Symptoms of Cardiomyopathy

The signs and symptoms of Cardiomyopathy may not be visible in the initial phase, but once the disorder has reached a more advanced stage, they will appear. A cardiomyopathy patient will exhibit the following signs and symptoms:

  • Edema in legs, feet and ankles, lungs and abdomen (swelling due to fluid buildup)
  • Unable to lie down due to continuous coughing. The patient will have to sit up and sleep (45 degree angle), instead of being able to lie down flat, to stop the coughing fit. Coughing can occur due to any strain within the body (like eating too quickly, exertion of any sort)
  • Breathlessness when walking or when exerting, and sometimes when at rest
  • Bloating of the abdomen (due to build-up of fluid)
  • Fatigue
  • Palpitations – a fluttery feeling, rapid heartbeats, pounding / irregular heartbeat
  • Occasional lightheadedness, dizziness / vertigo and a feeling of fainting
  • Inability to maintain balance, occasionally
  • Chest pain
  • Regardless of the type of cardiomyopathy a person has, the symptoms related above are common to all types of cardiomyopathy. This disease may progress very quickly in some and in some it could be over a period of years.

This disorder can be treated but the type of treatment depends on the type of cardiomyopathy a patient has and how serious it is. Types of treatment available are:

  • Medical (prescription of medications)
  • Surgical implants / implantation of devices
  • Transplantation (in very severe cases)

In many cases, especially those where the disease makes its appearance at a very later stage, doctors are unable to pinpoint the cause, but have been able to identify some of the contributing causes, which include:

  • Defect at birth due to genetic / hereditary factors
  • Disorders such as diabetes, thyroid disease or obesity
  • Heart Valve problems
  • Continuous condition of long term high blood pressure
  • Complications during pregnancy
  • Deficiencies of vital vitamins or minerals (thiamin B-1)
  • Consumption of too much alcohol over several years
  • Constant and continuously rapid heart beats
  • Infections of a certain type that injure the heart and cause cardiomyopathy
  • Hemochromatosis - buildup of Iron content in the heart muscle
  • Sarcoidosis – this is a disorder that causes lumps of cells to grow in the heart and other organs in the body
  • Amyloidosis – this causes abnormal buildup of proteins
  • CTD or Connective Tissue Disorders

Types of Cardiomyopathy
Hypertrophic Cardiomyopathy

  • Abnormal thickening of heart muscles particularly affecting the muscles of the left ventricle
  • Can develop at any age, but tends to be severe when it is apparent in childhood
  • In general, patients with this type of cardiomyopathy, have a family history of this disease
  • Genetic mutations have been associated with this type of cardiomyopathy

Dilated Cardiomyopathy

  • Most common type of cardiomyopathy
  • Generally affects men
  • Occurs mostly in middle-aged people
  • Affects the pumping ability of the heart – the left ventricle becomes less forceful. The left ventricle becomes dilated (enlarged) and cannot effectively pump blood out of the heart

Idiopathic or Restrictive Cardiomyopathy

  • The Heart muscles become rigid and less elastic
  • Prevents the heart from expanding and fills the heart with blood between heartbeats
  • Can occur at any age, generally affects people who are older
  • Is the least common type of cardiomyopathy and can occur for no reason
  • Can be caused due to diseases in other parts of the body (diseases such as buildup of Iron content in the heart muscle or buildup of abnormal amount of proteins, diseases that cause inflammations, or disorders of the blood causing blood cell damage to the heart – eosinophilic heart disease

Arrhythmogenic right ventricular dysplasia

  • Rare type of cardiomyopathy
  • Muscles in the lower right ventricle gets replaced by scar tissue
  • Causes heart rhythm problems
  • Caused by genetic mutations
  • Unclassified Cardiomyopathy
  • Types of cardiomyopathy that do not fit into any of the other types
  • Stress induced Cardiomyopathy
  • Also known as Broken Heart Syndrome or Takotsubo cardiomyopathy (tako tsubo refers

Management of Cardiomyopathy

Leading a healthy lifestyle, regular follow up with your doctor, taking medications as prescribed. 
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