Cardiomyopathy refers to heart muscle disease. The damaged heart does not effectively pump blood. The disease usually progresses to the point where patients develop life-threatening heart failure . In addition, people with cardiomyopathy are more likely to have irregular heartbeats or arrhythmias .
There are two major categories of cardiomyopathy: ischemic and nonischemic cardiomyopathy. Ischemic cardiomyopathy occurs when the heart muscle is damaged from heart attacks due to coronary artery disease . Nonischemic cardiomyopathy, the less common category, includes types of cardiomyopathy that are not related to coronary artery disease.
There are three main types of nonischemic cardiomyopathy:
In many cases, the exact cause is not known. Possible causes include:
The cause of the initial damage is often not found, but may include:
Causes may include:
This is usually related to another condition, such as:
A risk factor is something that increases your chance of getting a disease or condition.
Symptoms vary, depending on the type of cardiomyopathy and its severity. Patients with hypertrophic cardiomyopathy often do not notice any symptoms. Sudden cardiac death may be the first indication of the condition. In dilated cardiomyopathy, it may take years for symptoms to develop. Blood clots may form due to the abnormal pooling of blood in the heart. If a clot moves to another part of the body ( embolism ), symptoms associated with that organ (the brain, for example) may be the first sign of the heart disease.
Cardiomyopathy ultimately leads to heart failure and the following symptoms:
The doctor will:
Tests may include:
When heart failure is due to blockages in the coronary arteries, treatment directed at relieving these blockages through angioplasty , stent placement , or coronary artery bypass surgery may lead to improvements in heart function and symptoms. For certain genetic causes, other treatments may also lead to improvements in function. For many patients, however, treatment is aimed at relieving symptoms and prevent further damage.
Changes aim to eliminate anything that contributes to the disease or worsens symptoms:
Medications may include:
Surgical options include:
Aggressively treating hypertension, coronary artery diseases, and their risk factors is the best way to prevent most cases of cardiomyopathy. Other, less common causes, however, are not preventable. People with a family history of the disease should ask the doctor about screening tests, especially before starting an intense exercise program.
RESOURCES:
American Heart Association
http://www.americanheart.org
The Cardiomyopathy Association
http://www.cardiomyopathy.org/homepage.htm
CANADIAN RESOURCES:
Canadian Cardiovascular Society
http://www.ccs.ca/home/index_e.aspx
Canadian Family Physician
http://www.cfpc.ca/cfp/
References:
Braunwald E, Zipes DP, Libby P, et al. Heart Disease: A Textbook of Cardiovascular Medicine . 6th ed. Philadelphia, PA: WB Saunders Company; 2001.
Cecil RL, Goldman L, Bennett JC. Cecil Textbook of Medicine . 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
Dambro MR. Griffith's 5-Minute Clinical Consult . Philadelphia, PA: Lippincott Williams & Wilkins; 2001.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ . Accessed October 13, 2005.
Primary Care Medicine . 4th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2000.
Last reviewed November 2008 by Michael J. Fucci, DO
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