Cardiomyopathy - Cardiovascular Associates of Maryland
What is Cardiomyopathy?
Cardiomyopathy is the term for heart muscle disease. There is a
decrease in the heart’s ability to pump blood due to muscle weakness or
improper function.
Classifications
There are four types of classifications for cardiomyopathy:
- Ischemic Cardiomyopathy – The most common in
the United States. Weakened heart muscle is related to obstruction or
blockage of the coronary arteries or heart muscle injury caused by heart
attack. Cardiac catheterization is often performed to prove or disprove
this cause and to address high grade obstructions to blood flow to feed
threatened muscle tissue. Medications are geared toward optimizing
blood flow and reducing heart muscle workload.
- Dilated Cardiomyopathy – A common type of
cardiomyopathy in which the heart cavity (especially the left side) is
enlarged and the muscle is weak, diminishing the output of blood pumped
by the heart. Dilated cardiomyopathy can cause leaky valves, poor
output from the heart and occasionally formation of blood clots in the
heart. Some cases are caused by a genetic predisposition, a post viral
syndrome, toxins such as chemotherapy, cocaine or alcohol, or rarely may
be related to pregnancy or vitamin deficiency.
- Hypertrophic Cardiomyopathy – A genetic
disorder that causes the muscle of the left ventricle of the heart to
thicken which prevents the heart from pumping blood properly.
- Restrictive Cardiomyopathy – The walls of the
ventricle are rigid and do not allow for the normal filling of the heart
chambers with blood. This is a rare form of cardiomyopathy.
Symptoms
Symptoms of cardiomyopathy include:
- Patients with cardiomyopathy are prone to heart failure or retention of fluids
- Symptoms may include shortness of breath, chest pain, fatigue,
swollen feet, dizziness and fainting. Some patients experience abnormal
heart rhythms.
Treatment
Diet - Watching your salt intake and avoiding foods with high sodium can
help prevent fluid accumulation in patients with cardiomyopathy.
Medications include:
- Beta blockers (such as Carvedilol, Metoprolol) ACE inhibitors
(lisinopril, ramipril), ARBS (Diovan, Losartan, Avapro) and Nitrates,
all to decrease the work of the heart.
- Diuretics such as Lasix (furosemide) to rid the body of excess fluid that results in shortness of breath and swelling.
- Digoxin that can increase heart function.
- In patients with a hypertrophic cardiomyopathy calcium channel blockers have been shown to correct abnormal heart function.
- Coronary artery bypass surgery or stenting- if you have an
ischemic cardiomyopathy, improving blood flow through surgery or
stenting may improve heart function.
- Defibrillator- can help prevent life threatening heart rhythm
problems associated with cardiomyopathies. Bi Ventricular
defibrillators can improve heart function.
Discussion with your doctor
If you are told you have a cardiomyopathy discuss with your
doctor what he thinks is the cause. Since cardiomyopathies can run in
families discuss whether other family members should be screened.
You should also:
- Discuss what specific medicines and dietary changes will help.
- Discuss whether you may have an ischemic cardiomyopathy and
whether you need a catheterization to see if surgery or stenting may
help.
- If your heart function is reduced enough discuss with your doctor whether a defibrillator is advised.