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Heart Muscle Disease (Cardiomyopathy)

Cardiomyopathy is a group of diseases that affect the myocardium or the muscle of the heart usually leading to heart failure. It often occurs when the heart cannot pump as well as it should and is unable to maintain a normal electrical rhythm.

There are various types of cardiomyopathy. These falls into two major categories: "ischemic" and "non-ischemic" cardiomyopathy.

  • Dilated cardiomyopathy: It is the most common type of cardiomyopathy in which the pumping ability of the left ventricle becomes less forceful. In this condition the left ventricle becomes enlarged and is unable to effectively pump blood out of the heart. This type can affect people of all ages but it occurs mostly in middle-aged people and is more likely to affect men. A person with dilated cardiomyopathy may have a family history of this condition.
  • Ischemic cardiomyopathy: Ischemia results from inadequate oxygen supply to the cells causing the cells to die. The patches of dead muscle tissue do not contract, reducing the effectiveness of the heart. This condition is more common in older people who have other forms of cardiovascular disease.
  • Hypertrophic cardiomyopathy: It involves abnormal growth or thickening of the heart muscle, mainly affecting the muscle of the heart's main pumping chamber. It causes the heart to stiffen and shrink in size of the pumping chamber thus interfering with the heart's ability to deliver blood to the body. Hypertrophic cardiomyopathy can develop at any age, but this condition is more severe in cases of children.
  • Restrictive cardiomyopathy: The heart muscle in this condition becomes rigid and less elastic, which restricts the heart from properly expanding and filling with blood between heartbeats. Restrictive cardiomyopathy can occur at any age but it often affects older people.

Causes for Cardiomyopathy are

  • Long-term high blood pressure
  • Heart valve problems
  • Damage of heart tissue from an earlier heart attack
  • Metabolic disorders, such as thyroid disease or diabetes
  • Nutritional deficiencies caused by lack of vitamins or minerals.
  • Pregnancy
  • Excessive use of alcohol
  • Certain viral infections, which may injure the heart and trigger cardiomyopathy
  • Iron buildup in your heart muscle also known as hemochromatosis
  • Genetic conditions

Symptoms of Cardiomyopathy are

  • Breathlessness
  • Swelling of the legs, ankles and feet
  • Bloating of the abdomen
  • Fatigue
  • Irregular heartbeats
  • Dizziness

Treatment procedures for Cardiomyopathy are

  • Medications
    • Angiotensin-converting enzyme (ACE) inhibitors: It is used to improve the heart's pumping capability.
    • Beta blockers: They improve function of the heart
    • Diuretics: They make you urinate more frequently and keeps fluid from collecting in the body
  • Surgical and other procedure:
    • Septal myectomy: This is an open-heart operation in which the thickened, overgrown septum separating the two bottom heart chambers is removed. This improves blood flow and reduces mitral regurgitation. Myectomy is done when medications don't relieve symptoms.
    • Implantable cardioverter-defibrillator (ICD): It is a small device which is placed under the skin just below the collarbone to send electrical signals to the heart when it goes very fast. It is also helpful in regulating heartbeat.
    • Pacemaker: A small device called pacemaker is placed under the skin near the collarbone and connected to a pace wire positioned inside the heart. It delivers small electrical impulse which stimulates the heart to beat faster when it is going too slow.
    • Heart transplant and ventricular assist devices (VADs): In cases of severe cardiomyopathy a heart transplant is advised. Because of the shortage of donor hearts, in some cases, a mechanical heart assist device is used to help critically ill people. These devices, known as ventricular assist devices (VADs), increases blood circulation through the heart for months or even years.

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