Diseases of the heart muscle that make it rigid or thick and enlarge the heart and weaken it over time are referred to as cardiomyopathy. Hypertropic, restrictive, dilated, and arrhythmogenic right ventricular cardiomyopathy are some of the different classifications of cardiomyopathy. Cardiomyopathy may be an inherited or an acquired condition. Treatment options for cardiomyopathy depend on the severity of the symptoms, the age and physical condition of the patient, and other risk factors. Some patients may experience fatigue and shortness of breath or have trouble breathing. Others, particularly those with dilated and restrictive cardiomyopathy, might also notice swelling in the ankles, legs, feet, and abdomen as well as in the veins in the neck.
As with most heart-related problems, blood tests, chest X-rays, electrocardiogram, echocardiography, and cardiac magnetic resonance imaging are some of the cardiomyopathy tests that a doctor may prescribe. Blood tests reveal cholesterol levels as well as iron and hormone levels in the blood. Blood tests to check kidney and liver function may also be required.
Among cardiomyopathy causes, coronary heart disease is what is most often encountered. Scarring of the heart muscle caused by heart attacks, narrowing and hardening of arteries due to the build-up of plaque on the walls of the arteries, and heart valve problems, all contribute to the reduced pumping ability of the heart. Infections caused by viruses such as HIV can also cause the deterioration of heart muscle functions. Long-term abuse of alcohol and illicit drugs such as cocaine places a strain on the heart, eventually leading to alcoholic cardiomyopathy. Complications arising out of long-term metabolic disorders like diabetes and thyroid disorders could also include cardiomyopathy. Besides anti-depressants, certain drugs used in the treatment of cancer are also known to cause this disease. Certain toxins like cobalt and a toxic build-up of iron in the heart muscle also act as triggers for cardiomyopathy. Dilated cardiomyopathy is often the consequence of diseases of the heart valve or coronary artery disease. Some cases of dilated cardiomyopathy are idiopathic as the causes are not known. Dilated cardiomyopathy and hypertropic cardiomyopathy are often inherited conditions, and families of those with the disease need to be screened regularly for dilated cardiomyopathy. Thickening or stiffening of heart muscle can obstruct blood flow in the ventricles and slow down filling up of the heart in patients with hypertropic cardiomyopathy, making them susceptible, at times, to shortness of breath and even sudden death. Some women get cardiomyopathy after childbirth, and hence, this condition is called postpartum cardiomyopathy.
Lifestyle changes involving dietary modifications and the inclusion of moderate physical exercise are recommended for patients with cardiomyopathy. One dietary change involving the use of fresh food as against processed foods that contain more salt is imperative for patients of cardiomyopathy. Smoking is a major risk factor associated with cardiac problems, and patients are advised to quit smoking. Alcohol intake should be considerably reduced if not altogether stopped as it is another leading factor contributing to liver disorders, obesity, and alcoholic cardiomyopathy. Substance abuse can be directly linked to cardiomyopathy and cocaine users have been able to reverse cardiomyopathy if the problem is detected early and the use of cocaine is stopped.
Based on the results of blood tests, chest X-ray, and (EKG) electrocardiogram, the doctor can decide on the course of treatment to control the symptoms and stop the disease from getting worse.
For those with dilated cardiomyopathy, along with medication prescribed, surgical implants like a pacemaker or a defibrillator may be considered to take care of problems related to arrhythmia. Medication to reduce blood pressure, to prevent the formation of blood clots, antiarrhytmics, beta blockers, and calcium channel blockers are also prescribed (based on physical examination and the results of diagnostic tests such as stress tests and ankle/brachial index) for those with hardened arteries or ischemic cardiomyopathy and hypertropic cardiomyopathy. Diuretics to prevent water and sodium retention and medicines to regulate blood pressure are prescribed to those with restrictive cardiomyopathy.
Cardiac catheterization may be done to check for the need to perform an angiopolasty or a coronary artery bypass in case of those with blocked arteries, so that blood supply to weakened heart muscle may be improved. This procedure also helps to measure the pressure of the blood flow in the chambers of the heart and check the functioning of the heart. Coronary angiography and left heart catheterization combined with myocardial biopsy are found to be far more accurate in diagnosing idiopathic dilated cardiomyopathy than non-invasive techniques like echocardiography. The tissue sample recovered during myocardial biopsy helps the physician understand the extent of the damage to heart tissue. Sometimes, doctors may prefer to use a cardiac MRI technique along with echocardiography to get clearer images of the heart. Those with a family history of cardiomyopathy or other heart-related disorders may opt for genetic testing so that they can determine if they carry the disease causing gene and opt for regular heart exams if they do.