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CardioMyopathy

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Overview
Cardiomyopathy (kahr-dee-o-my-OP-uh-thee) is a disease of the heart muscle that makes it harder for your heart to pump blood to the rest of your body. Cardiomyopathy can lead to heart failure.

The main types of cardiomyopathy include dilated, hypertrophic and restrictive cardiomyopathy. Treatment — which might include medications, surgically implanted devices or, in severe cases, a heart transplant — depends on which type of cardiomyopathy you have and how serious it is.

Symptoms
There might be no signs or symptoms in the early stages of cardiomyopathy. But as the condition advances, signs and symptoms usually appear, including:

Breathlessness with exertion or even at rest
Swelling of the legs, ankles and feet
Bloating of the abdomen due to fluid buildup
Cough while lying down
Fatigue
Heartbeats that feel rapid, pounding or fluttering
Chest discomfort or pressure
Dizziness, lightheadedness and fainting
Signs and symptoms tend to get worse unless treated. In some people, the condition worsens quickly; in others, it might not worsen for a long time.

When to see a doctor
See your doctor if you have one or more signs or symptoms associated with cardiomyopathy. Call 911 or your local emergency number if you have severe difficulty breathing, fainting or chest pain that lasts for more than a few minutes.

Because some types of cardiomyopathy can be hereditary, if you have it your doctor might advise that your family members be checked.

Causes
Often the cause of the cardiomyopathy is unknown. In some people, however, it's the result of another condition (acquired) or passed on from a parent (inherited).

Contributing factors for acquired cardiomyopathy include:

Long-term high blood pressure
Heart tissue damage from a heart attack
Chronic rapid heart rate
Heart valve problems
Metabolic disorders, such as obesity, thyroid disease or diabetes
Nutritional deficiencies of essential vitamins or minerals, such as thiamin (vitamin B-1)
Pregnancy complications
Drinking too much alcohol over many years
Use of cocaine, amphetamines or anabolic steroids
Use of some chemotherapy drugs and radiation to treat cancer
Certain infections, especially those that inflame the heart
Iron buildup in your heart muscle (hemochromatosis)
A condition that causes inflammation and can cause lumps of cells to grow in the heart and other organs (sarcoidosis)
A disorder that causes the buildup of abnormal proteins (amyloidosis)
Connective tissue disorders
Types of cardiomyopathy include:

Dilated cardiomyopathy. In this type of cardiomyopathy, the pumping ability of your heart's main pumping chamber — the left ventricle — becomes enlarged (dilated) and can't effectively pump blood out of the heart.

Although this type can affect people of all ages, it occurs most often in middle-aged people and is more likely to affect men. The most common cause is coronary artery disease or heart attack.

Hypertrophic cardiomyopathy. This type involves abnormal thickening of your heart muscle, particularly affecting the muscle of your heart's main pumping chamber (left ventricle). The thickened heart muscle can make it harder for the heart to work properly.

Hypertrophic cardiomyopathy can develop at any age, but the condition tends to be more severe if it becomes apparent during childhood. Most affected people have a family history of the disease, and some genetic mutations have been linked to hypertrophic cardiomyopathy.

Restrictive cardiomyopathy. In this type, the heart muscle becomes rigid and less elastic, so it can't expand and fill with blood between heartbeats. This least common type of cardiomyopathy can occur at any age, but it most often affects older people.

Restrictive cardiomyopathy can occur for no known reason (idiopathic), or it can by caused by a disease elsewhere in the body that affects the heart, such as when iron builds up in the heart muscle (hemochromatosis).

Arrhythmogenic right ventricular dysplasia. In this rare type of cardiomyopathy, the muscle in the lower right heart chamber (right ventricle) is replaced by scar tissue, which can lead to heart rhythm problems. It's often caused by genetic mutations.

Unclassified cardiomyopathy. Other types of cardiomyopathy fall into this category.

Risk factors
There are a number of factors that can increase your risk of cardiomyopathy, including:

Family history of cardiomyopathy, heart failure and sudden cardiac arrest
Long-term high blood pressure
Conditions that affect the heart, including a past heart attack, coronary artery disease or an infection in the heart (ischemic cardiomyopathy)
Obesity, which makes the heart work harder
Long-term alcohol abuse
Illicit drug use, such as cocaine, amphetamines and anabolic steroids
Certain chemotherapy drugs and radiation therapy for cancer
Certain diseases, such as diabetes, an under- or overactive thyroid gland, or a disorder that causes the body to store excess iron (hemochromatosis)
Other conditions that affect the heart, such as a disorder that causes the buildup of abnormal proteins (amyloidosis), a disease that causes inflammation and can cause lumps of cells to grow in the heart and other organs (sarcoidosis), or connective tissue disorders
Complications
Cardiomyopathy can lead to other heart conditions, including:

Heart failure. Your heart can't pump enough blood to meet your body's needs. Untreated, heart failure can be life-threatening.
Blood clots. Because your heart can't pump effectively, blood clots might form in your heart. If clots enter your bloodstream, they can block the blood flow to other organs, including your heart and brain.
Valve problems. Because cardiomyopathy causes the heart to enlarge, the heart valves might not close properly. This can lead to a backward flow of blood.
Cardiac arrest and sudden death. Cardiomyopathy can lead to abnormal heart rhythms. These abnormal heart rhythms can result in fainting or, in some cases, sudden death if your heart stops beating effectively.
Prevention
In many cases, you can't prevent cardiomyopathy. Let your doctor know if you have a family history of the condition.

You can help reduce your chance of cardiomyopathy and other types of heart disease by living a heart-healthy lifestyle and making lifestyle choices such as:

Avoiding the use of alcohol or cocaine
Controlling high blood pressure, high cholesterol and diabetes
Eating a healthy diet
Getting regular exercise
Getting enough sleep
Reducing your stress

Dr. Tushar Dorage
Dr. Tushar Dorage
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Dr. Geeta Dharmatti
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Dr. Vijaykumar Raut
Dr. Vijaykumar Raut
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Dr. Sandeep Sandbhor
Dr. Sandeep Sandbhor
MS/MD - Ayurveda, General Medicine Physician, 16 yrs, Pune
Dr. Chhaya Helambe
Dr. Chhaya Helambe
BAMS, Ayurveda Family Physician, 20 yrs, Pune
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