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Cardiomyopathy

Heart muscles play a vital role in the efficient functioning of the heart and effective pumping of blood to the entire body. If these muscles are damaged, the function of heart is disturbed and the blood is not pumped to the entire body in an appropriate manner. This condition is known as cardiomyopathy. It can be categorised into two types – dilated and hypertrophic cardiomyopathy.

Dilated cardiomyopathy
In dilated cardiomyopathy the muscles of the walls of the heart become weak and damaged. The weakened muscles tend to stretch, thus causing heart enlargement. This in turn reduces the heart’s efficiency to pump blood.

Symptoms of dilated cardiomyopathy
It is difficult to detect dilated cardiomypathy during the initial stages. The symptoms develop gradually and over a period of several years. The symptoms may include:

  • Fatigue
  • Palpitations
  • Breathlessness on exertion
  • Swollen ankles

The symptoms aggravate as the condition progresses. There are also other complications that may arise due to this condition (enlargement might affect the valves, leading to leakage). This can eventually cause arrhythmia and also lead to heart failure.

Causes
Dialated cardiomyopathy is more common in males, and the risk increases with age. The underlying causes may include:

  • Alcohol addiction and abuse
  • An autoimmune disorder (in which the body attacks its own tissues)
  • A viral illness
  • Some anti-cancer drugs

Diagnosis
Various tests are carried out to diagnose dilated cardiomyopathy. The tests are mainly performed to rule out the possibility of a coronary artery disease. The diagnosis involves an ECG, an exercise ECG, and an ambulatory ECG. They respectively measure your heart’s electrical activity during rest, during exercise, and throughout the day as you perform your daily routine activities. An echo-cardiography might be carried out to image the interior of the heart. An X-ray can also be taken to determine the enlargement, which is a result of dilated cardiomayopathy. If your doctor suspects  coronary artery disease, a coronary angiography can help to rule out the condition. The angiography includes passing a cardiac catheter through an artery into the heart to measure the blood pressure and gauge the efficiency of the valves.

Treatment
It is difficult to zero down on a specific line of treatment if the cause is not detected. If the condition is a result of alcohol abuse, curbing consumption can help. Your doctor might prescribe drugs such as digoxin to improve the function. Further deterioration of the condition can be prevented by drugs such as beta blockers and ACE inhibitors. In case the condition worsens and cannot be treated with drugs, a transplant may be the only last option.

Hypertrophic cardiomyopathy
In hypertrophic cardiomyopathy, the walls of the muscles of the heart thicken abnormally. Thickening causes partial blockage of the blood vessels, and this prevents the heart from receiving the full quantity of blood, thus reducing its pumping efficiency.

Symptoms
The symptoms of hypertrophic cardiomyopathy are first seen when the patient experiences exertion. They may include:

  • Breathlessness
  • Chest pain
  • Dizziness or fainting
  • Palpitations

If hypertrophic cardiomyopathy is not treated properly and on time, it might lead to arrhythmia and mitral incompetence (distortion of the mitral valve). In extreme cases of hypertrophic cardiomyopathy, the thickening of the walls may obstruct the outflow of blood from the heart and lead to inadequate blood supply.

Causes
Hypertrophic cardiomyopathy more commonly develops during adolescence. In some cases it may get delayed until middle age. Hypertrophic cardiomyopathy is hereditary, however, the actual cause is still unknown.

Diagnosis
Hypertrophic cardiomyopathy can be diagnosed through a series of tests. An ECG (electrocardiography) is carried out to measure the electrical activity. An exercise ECG and ambulatory ECG can also be carried out to measure the activity of the heart during exercise, exertion, and while you carry out your chores throughout the day. Heart imaging can also be done by carrying out an echo-cardiography to determine the degree of damage and obstruction of blood flow due to thickening of the muscles of the walls.

Treatment
A person suffering from hypertrophic cardiomyopathy is more susceptible to an infection of the heart lining or the valves. Hypertrophic cardiomyopathy can be treated with beta blockers and calcium channel blockers. These drugs help to improve the filling capacity of the heart. Your doctor may prescribe anti-arrhythmic drugs to regulate the rhythm of the heart. The thickened muscles can also be surgically removed or a procedure called septal ablation may be adopted. In this procedure, a small quantity of alcohol is injected into the arteries that carry blood to the affected muscle. Alcohol shrinks the thickened muscle to normal size, making way for the blood to flow out smoothly. A transplant may also be advised in case of extreme damage, however, it is done only in very rare cases.

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