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Heart muscle disease (cardiomyopathy)

Cardiomyopathy refers to diseases of the heart muscle. These diseases have many causes, signs and symptoms, and treatments.

In cardiomyopathy, the heart muscle becomes enlarged, thick or stiff. In rare cases, the muscle tissue in the heart is replaced by scar tissue.

As cardiomyopathy worsens, the heart becomes weaker. It is less able to pump blood around the body and maintain a normal electrical rhythm. This can lead to heart failure or an irregular heartbeat called arrhythmias. Heart failure, in turn, can cause fluid to build up in the lungs, ankles, feet, legs, or abdomen.

The weakening of the heart can also cause other complications such as heart valve problems.

Overview

The types of cardiomyopathy are:

  • Hypertrophic cardiomyopathy
  • Dilated cardiomyopathy
  • Restrictive Cardiomyopathy
  • Arrhythmogenic right ventricular dysplasia
  • Unclassified cardiomyopathy

Cardiomyopathy can be acquired or inherited. “Acquired” means that you are not born with the disease, but that you develop it from another disease, condition or factor. "Inherited" means that your parents passed on the gene for the disease to you. Often the cause of cardiomyopathy is unknown.

Cardiomyopathy can affect people of all ages. However, people in certain age groups are more likely to have certain types of cardiomyopathy. This article focuses on cardiomyopathy in adults.

Symptoms

Some people with cardiomyopathy never have any signs or symptoms. Others have no signs or symptoms in the early stages of the disease.

As cardiomyopathy worsens and the heart weakens, signs and symptoms of heart failure usually occur. These signs and symptoms include:

  • Shortness of breath or trouble breathing, especially with physical exertion
  • Fatigue (tiredness)
  • Swelling in the ankles, feet, legs, abdomen and veins in the neck

Other signs and symptoms include dizziness; feeling light-headed; fainting during physical activity; arrhythmias (irregular heartbeat); chest pain, especially after exercise or heavy meals; and heart murmurs. (Heart murmurs are extra or unusual sounds heard during a heartbeat.)

Therapy

People who have cardiomyopathy but don't have any signs or symptoms may not need treatment. Sometimes dilated cardiomyopathy that comes on suddenly can go away on its own. Other people with cardiomyopathy need treatment. Treatment depends on the type of cardiomyopathy you have, the severity of your symptoms and complications, and your age and overall health. Treatments can include:

  • Heart-healthy lifestyle changes
  • Medicines
  • Non-surgical procedure
  • Surgery and Implanted Devices

The main goals of cardiomyopathy treatment include:

  • Control signs and symptoms so that you can live as normally as possible
  • Dealing with conditions that cause or contribute to the disease
  • Reduce complications and the risk of sudden cardiac arrest
  • Prevent the disease from getting worse

Changes in the heart-healthy lifestyle

Your doctor may suggest lifestyle changes to treat a condition causing your cardiomyopathy, including:

  • Heart-healthy eating
  • Strive for a healthy weight
  • Deal with stress
  • Fysical activity
  • Quit smoking

Medicines

Many medications are used to treat cardiomyopathy. Your doctor can prescribe medications to:

  • Balance electrolytes in your body . Electrolytes are minerals that help maintain moisture levels and the acid-base balance in the body. They also help keep muscle and nervous tissue working properly. Abnormal electrolyte levels can be a sign of dehydration (lack of water in your body), heart failure, high blood pressure or other conditions. Aldosterone blockers are an example of a drug used to balance electrolytes.
  • Keep your heart beating at a normal rhythm . These medicines, called anti-arrhythmics, help prevent arrhythmiasomen.
  • Lower your blood pressure . ACE inhibitors, angiotensin II receptor blockers, beta blockers and calcium channel blockers are examples of drugs that lower blood pressure.
  • Prevent blood clots from forming . Anticoagulants or blood thinners are an example of a drug that prevents blood clots. Blood thinners are often used to prevent blood clots from forming in people with dilated cardiomyopathy.
  • Reduce inflammation . Corticosteroids are an example of a drug used to reduce inflammation.
  • Remove excess sodium from your body . Diuretics, or water pills, are an example of medicines that help remove excess sodium from the body, reducing the amount of water in your blood.
  • Lower your heart rate . Beta blockers, calcium channel blockers and digoxin are examples of drugs that slow the heart rate. Beta blockers and calcium channel blockers are also used to lower blood pressure.

Use all medications regularly, as directed by your doctor. Do not change the amount of your medicine or skip a dose unless your doctor tells you to.

Surgery and Implanted Devices

Doctors use a variety of surgeries to treat cardiomyopathy, including septal myectomy, surgically implanted devices, and heart transplants.

SEPTAL MYECTOMY

Septal myectomy is open heart surgery and is used to treat people with hypertrophic cardiomyopathy and severe symptoms. This procedure is generally used for younger patients and those whose drugs are not working properly.

A surgeon removes part of the thickened septum that is protruding in the left ventricle of the heart. This improves blood flow through the heart and to the body. The removed tissue does not grow back. If necessary, the surgeon can repair or replace the mitral valve at the same time. Septal myectomy is often successful and allows you to return to a normal life without symptoms.

SURGICAL IMPLANTED EQUIPMENT

Surgeons can place different types of devices in the heart to improve function and symptoms, including:

  • Cardiac Resynchronization Therapy (CRT) Device . A CRT machine coordinates the contractions between the left and right ventricles of the heart.
  • Implantable Cardioverter Defibrillator (ICD) . An ICD helps control life-threatening arrhythmias that can lead to sudden cardiac arrest. This small device is implanted in the chest or abdomen and connected to the heart with wires. If an ICD senses a dangerous change in the heart rhythm, it will send an electric shock to the heart to restore a normal heart rate.
  • Left Ventricular Auxiliary Device (LVAD) . This device helps the heart to pump blood to the body. An LVAD can be used as a long-term therapy or as a short-term treatment for people waiting for a heart transplant.
  • Pacemaker . This small device is placed under the skin of your chest or abdomen to control arrhythmias. The device uses electrical pulses to make the heart beat at a normal speed.

HEART TRANSPLANT

For this operation, a surgeon replaces a person's sick heart with a healthy heart from a deceased donor. A heart transplant is a last resort for people with end-stage heart failure. "End stage" means that the condition has become so severe that all treatments except a heart transplant have failed. To learn more about this treatment, visit the Heart Transplant Health topic.

Non-surgical procedure

Doctors can use a non-surgical procedure called alcohol septal ablation to treat cardiomyopathy. During this procedure, the doctor injects ethanol (a type of alcohol) through a tube into the small artery that carries blood to the thickened area of ​​the heart muscle. The alcohol kills cells and the thickened tissue shrinks to a more normal size. This procedure allows blood to flow freely through the ventricle, which improves symptoms.

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