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Cardiomyopathy

Cardiomyopathy is disease in which the heart muscle becomes weakened, stretched, or has another structural problem. It often occurs when the heart cannot pump or function well.

Most people with cardiomyopathy have heart failure.

Dilated cardiomyopathy involves enlargement of the heart muscle and is the most common type of cardiomyopathy. The heart muscle is weakened and cannot pump blood efficiently. Decreased heart function affects the lungs, liver, and other body systems.

Causes

There are many types of cardiomyopathy, with different causes:

Dilated cardiomyopathy is a condition in which the heart becomes weak and the chambers get large. As a result, the heart cannot pump enough blood out to the body. It can be caused by many medical problems.

Dilated cardiomyopathy involves enlargement of the heart muscle and is the most common type of cardiomyopathy. The heart muscle is weakened and cannot pump blood efficiently. Decreased heart function affects the lungs, liver, and other body systems.

Hypertrophic cardiomyopathy (HCM) is a condition in which the heart muscle becomes thick. This makes it harder for blood to leave the heart. This type of cardiomyopathy is most often passed down through families.

Hypertrophic cardiomyopathy is the thickening of the muscles that make up the heart. The thickening may interfere with the normal functioning of the heart by narrowing the outflow of the ventricle; reducing the ability of the heart to relax and fill with blood during the relaxation phase; or reducing the ability of the valves of the heart to function properly. Any situation that increases the contraction or rate of contraction of the heart muscle can worsen these symptoms.

Ischemic cardiomyopathy is caused by a narrowing of the arteries that supply the heart with blood. It makes the heart walls thin so they do not pump well.

Restrictive cardiomyopathy is a group of disorders. The heart chambers are unable to fill with blood because the heart muscle is stiff. The most common causes of this type of cardiomyopathy are amyloidosis and scarring of the heart from an unknown cause.

Peripartum cardiomyopathy occurs during pregnancy or in the first 5 months afterward.

Peripartum cardiomyopathy is a rare disorder in which a weakened heart is diagnosed within the last month of pregnancy or within 5 months after delivery, without other identifiable causes for dysfunction of the heart. The heart muscle becomes enlarged and weakened and cannot pump blood efficiently. Decreased heart function affects the lungs, liver, and other body systems.

Treatment

When possible, the cause of cardiomyopathy is treated. Medicines and lifestyle changes are often needed to treat the symptoms of heart failure, angina, and abnormal heart rhythms.

Procedures or surgeries may also be used, including:

  • A defibrillator that sends an electrical pulse to stop life-threatening abnormal heart rhythms
  • A pacemaker that treats a slow heart rate or helps both sides of the heart beat at the same time
  • Coronary artery bypass (CABG) surgery or angioplasty that may improve blood flow to the damaged or weakened heart muscle
  • Heart transplant that may be tried when all other treatments have failed

Recently, implantable artificial heart pumps have been developed. These may be used for very severe cases. However, not all patients need or are able to have this advanced treatment.

Outlook (Prognosis)

The outlook depends on many different things, including:

  • Cause and type of cardiomyopathy
  • How well the condition responds to treatment
  • The severity of the heart problem

Heart failure is usually a long-term (chronic) illness. It may get worse over time. Some people develop severe heart failure. In this case, medicines, surgery, and other treatments may no longer help.

Patients with certain types of cardiomyopathy are at risk for dangerous heart rhythm problems.

References

Shammas NW, Padaria RF, Coyne EP. Pericarditis, myocarditis, and other Cardiomyopathies. Prim Care Clin Office Pract

Hare JM. The dilated, restrictive, and infiltrative cardiomyopathies. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds.Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine

Wexler RK, Elton T, Pleister A, Feldman D. Cardiomyopathy: An overview. Am Fam Physician

Update Date 5/13/2014

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