What Is Cardiomyopathy?
Cardiomyopathy (KAR-de-o-mi-OP-a-the) refers to
diseases of the heart muscle. These diseases have a variety of causes,
symptoms, and treatments. In cardiomyopathy, the heart muscle becomes enlarged
or abnormally thick or rigid. In rare cases, the muscle tissue in the heart is
replaced with scar tissue.
As cardiomyopathy progresses, the heart becomes
weaker and less able to pump blood through the body. This can lead to
heart
failure,
arrhythmias (ah-RITH-me-ahs; abnormal heart rhythms), fluid
buildup in the lungs or legs, and, more rarely,
endocarditis (a bacterial infection of the lining of the
heart). The weakening of the heart also can lead to other severe
complications.
The four main types of cardiomyopathy are:
- Dilated cardiomyopathy
- Hypertrophic (hi-per-TROF-ik) cardiomyopathy
- Restrictive cardiomyopathy
- Arrhythmogenic (a-rith-mo-JEN-ik) right
ventricular dysplasia (ARVD)
Cardiomyopathy can have a specific cause, such as
damage to the heart from a
heart
attack,
high
blood pressure, or a viral infection. Some types of cardiomyopathy are
caused by a gene mutation and run in families. In many cases, the cause is
unknown.
Cardiomyopathy can affect people of all ages, from
babies to older adults. However, certain age groups are more likely to have
certain types of cardiomyopathy. Treatment may involve medicines, surgery,
nonsurgical procedures, and lifestyle changes.
Outlook
Some people live long, healthy lives in spite of
having cardiomyopathy. Some people don't even realize that they have the
disease because they have no symptoms. In other people, the disease develops
rapidly, symptoms are severe, and serious complications develop. Current
treatments can reduce symptoms and complications of cardiomyopathy.
Types of Cardiomyopathy
Dilated Cardiomyopathy
Dilated cardiomyopathy is the most common form of
cardiomyopathy. It generally occurs in adults aged 20 to 60 years. Men are more
likely than women to develop dilated cardiomyopathy.
Dilated cardiomyopathy affects the heart's
ventricles (VEN-trih-kuls) and atria. The ventricles are the two lower chambers
of the heart, and the atria are the two upper chambers. Dilated cardiomyopathy
usually starts in the left ventricle, where the heart muscle begins to dilate
or stretch and become thinner. This leads to enlargement of the inside of the
ventricle. The problem often spreads to the right ventricle and then to the
atria as the disease gets worse.
When the chambers dilate, the heart can't pump blood
very well. The heart tries to cope by dilating the chambers even more. Over
time, the heart becomes weaker and
heart
failure can occur. Symptoms of heart failure include feeling tired,
swelling of the legs and feet, and shortness of breath. Dilated cardiomyopathy
also can lead to heart valve problems,
arrhythmias, and blood clots in the heart. Having advanced
dilated cardiomyopathy is a common reason for needing a heart transplant.
Up to one-half of all cases of dilated
cardiomyopathy may be hereditary (passed down in the genes from parent to
child). These cases are called familial dilated cardiomyopathy. Dilated
cardiomyopathy also can be a complication of many conditions, including
coronary
artery disease and
high
blood pressure. It also can be caused by viral infections, excessive use of
alcohol, and exposure to certain drugs (including cocaine, amphetamines, and
some drugs used in cancer treatments). In some cases, no cause can be
found.
Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy occurs when the heart
muscle thickens abnormally. The thickening generally happens in the left
ventricle, the heart's main pumping chamber. This type of cardiomyopathy can
affect people of any age.
Hypertrophic cardiomyopathy can be obstructive or
nonobstructive. In the obstructive type, the septum (the wall that divides the
left and right sides of the heart) thickens and bulges into the left ventricle.
This bulge blocks the flow of blood out of the ventricle. The ventricle must
work much harder to pump blood past the blockage and out to the body. Symptoms
can include chest pain, dizziness, shortness of breath, or fainting.
Obstructive hypertrophic cardiomyopathy also can
affect the heart's mitral (MI-trul) valve, causing blood to leak backward
through the valve.
In nonobstructive hypertrophic cardiomyopathy, the
thickened heart muscle does not block the flow of blood out of the ventricle.
The entire ventricle may become thicker (symmetric ventricular hypotrophy) or
it may happen only at the bottom of the heart (apical hypertrophy). The right
ventricle also may be affected.
In both kinds of hypertrophic cardiomyopathy, the
thickened muscle makes the inside of the left ventricle smaller so that it
holds less blood. The walls of the ventricles also may become stiff. As a
result, they are less able to relax and fill with blood. This causes increased
pressure in the ventricles and the blood vessels of the lungs. Changes also
occur to the cells in the damaged heart muscle. This may interfere with the
heart's electrical signals, leading to arrhythmias.
Some people with hypertrophic cardiomyopathy have no
symptoms, and the condition does not affect their lives. Others have severe
symptoms or develop complications such as serious arrhythmias. A few people
with the condition have sudden cardiac arrest because of dangerous arrhythmias.
Hypertrophic cardiomyopathy can be inherited because
of a gene mutation or develop over time because of
high
blood pressure or aging. Often, the cause is unknown.
Restrictive Cardiomyopathy
Restrictive cardiomyopathy tends to mostly affect
older adults. In this cardiomyopathy, the ventricles become stiff and rigid due
to replacement of the normal heart muscle with abnormal tissue, such as scar
tissue. As a result, the ventricles cannot relax normally and expand to fill
with blood, which causes the atria to become enlarged. Eventually, blood flow
in the heart is reduced, and complications such as heart failure or arrhythmias
occur.
Restrictive cardiomyopathy can occur for no known
reason, or it can develop because the person has another disease. Some of the
diseases that can cause restrictive cardiomyopathy include hemochromatosis,
sarcoidosis,
amyloidosis, and connective tissue disorders. Restrictive cardiomyopathy also
can occur as a result of radiation treatments, infections, or scarring after
surgery.
Arrhythmogenic Right Ventricular Dysplasia
Arrhythmogenic right ventricular dysplasia (ARVD) is
a rare type of cardiomyopathy. ARVD develops when the muscle tissue in the
right ventricle dies and is replaced with scar tissue. This process causes
problems in the heart's electrical signaling, resulting in arrhythmias.
Symptoms include a feeling of strong or irregular heartbeats (palpitations) and
fainting after exercise.
ARVD usually develops in teens or young adults and
is often the cause of sudden cardiac death in young athletes. ARVD is thought
to be an inherited disease.
Other Names for Cardiomyopathy
- Dilated cardiomyopathy
- Familial dilated cardiomyopathy
- Congestive cardiomyopathy
- Idiopathic dilated cardiomyopathy
- Hypertrophic cardiomyopathy
- Hypertrophic obstructive cardiomyopathy
- Asymmetric septal hypertrophy
- Idiopathic hypertrophic subaortic stenosis
- Familial hypertrophic cardiomyopathy
- Arrhythmogenic right ventricular dysplasia
- Right ventricular dysplasia
- Right ventricular cardiomyopathy
- Restrictive cardiomyopathy
- Arrhythmogenic ventricular cardiomyopathy
What Causes Cardiomyopathy?
Many times, the cause of cardiomyopathy is unknown.
When this happens, the disease is called idiopathic (or primary)
cardiomyopathy. The majority of cardiomyopathies in children are
idiopathic.
Sometimes, cardiomyopathy is inherited (passed down
in the genes from parent to child) or caused by another disease or condition.
Dilated Cardiomyopathy
Dilated cardiomyopathy can be inherited. It also can
be caused by certain diseases, conditions, and substances, including:
- Coronary
artery disease and
heart
attacks (ischemic cardiomyopathy)
- Infections, especially viral infections that
cause the heart muscle to become inflamed (myocarditis)
- Alcohol, especially when a person has a poor diet
(alcoholic cardiomyopathy)
- Complications during the last month of pregnancy
or within 5 months of birth (peripartum cardiomyopathy)
- Certain toxins, such as cobalt
- Certain drugs, such as cocaine, amphetamines, and
two medicines used to treat cancer (doxorubicin and daunorubicin)
- Diseases such as diabetes and thyroid
disease
Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy can be inherited. It
also can develop over time because of high blood pressure or aging. Often, the
cause of hypertrophic cardiomyopathy is unknown.
Restrictive Cardiomyopathy
Certain diseases and conditions can cause
restrictive cardiomyopathy, including:
- Hemochromatosis, a condition in which too much
iron is deposited into tissues, including heart tissue
- Amyloidosis, a disease in which abnormal proteins
are deposited into heart tissue
- Sarcoidosis,
a disease in which inflammation produces tiny lumps of cells in various organs
in the body, including the heart
- Connective tissue disorders
Arrhythmogenic Right Ventricular Dysplasia
Arrythmogenic right ventricular dysplasia is thought
to be an inherited disease.
Who Is At Risk for Cardiomyopathy?
Populations Affected
People of all ages can develop cardiomyopathy, but
certain cardiomyopathies are more common in certain groups:
- African Americans are more likely to have dilated
cardiomyopathy compared to Caucasians.
- Men are more likely to have dilated
cardiomyopathy compared to women.
- Teens and young adults are more likely to have
arrhythmogenic right ventricular dysplasia compared to older people.
Major Risk Factors
Major risk factors for developing cardiomyopathy
include:
- Having a family history of cardiomyopathy,
heart
failure, or sudden cardiac death
- Having a disease or condition that can lead to
cardiomyopathy, such as:
- Diseases that can damage the heart (for example,
hemochromatosis,
sarcoidosis,
or amyloidosis)
- Long-term alcoholism
- Long-term
high
blood pressure
- Diabetes and other metabolic diseases
Some people with cardiomyopathy never have symptoms.
That is why it's important to identify people who may be at high risk for this
disease so that potential problems (such as serious
arrhythmias or sudden cardiac death) can be prevented.
What Are the Signs and Symptoms of
Cardiomyopathy?
Some people with cardiomyopathy never have symptoms,
and others have no symptoms in the early stages of the disease. As
cardiomyopathy progresses and the heart weakens, signs and symptoms of
heart
failure usually appear. These signs and symptoms include:
- Tiredness
- Weakness
- Shortness of breath after exercise or even at
rest
- Swelling of the abdomen, legs, ankles, and
feet
Other signs and symptoms can include dizziness,
lightheadedness, fainting during exercise, abnormal heart rhythms (arrhythmias), and an extra or unusual sound heard during the
heartbeat (heart
murmur).
How Is Cardiomyopathy Diagnosed?
If cardiomyopathy is suspected, the diagnosis is
based on a person's:
- Symptoms and medical history
- Family history of cardiomyopathy,
heart
failure, or sudden cardiac arrest
- Physical exam
- Results on diagnostic tests and procedures
The physical exam will identify a number of findings
in patients with cardiomyopathy. The doctor will use a stethoscope to listen to
the person's heart and lungs for sounds that may suggest the presence of
cardiomyopathy. These sounds may even indicate a certain type of
cardiomyopathy. For example, the loudness, timing, and location of a
heart
murmur may suggest that a person has hypertrophic obstructive
cardiomyopathy. A "crackling" sound in the lungs may be a sign of heart
failure, which often develops in the later stages of cardiomyopathy.
Physical signs also help the doctor diagnose
cardiomyopathy. Swelling of the abdomen, legs, or feet may indicate excess
fluid, which is a sign of heart failure.
Sometimes, doctors discover cardiomyopathy during a
routine exam if they hear a heart murmur or if the patient has an abnormal
electrocardiogram (see Diagnostic Tests and Procedures below).
Specialists Involved
Often a cardiologist or pediatric cardiologist is
involved in the care of a patient with cardiomyopathy. A cardiologist is a
doctor who specializes in heart diseases. A pediatric cardiologist specializes
in children's heart diseases.
Diagnostic Tests and Procedures
Doctors may order one or more tests to diagnose
cardiomyopathy, including:
- EKG
(electrocardiogram). This test measures the rate and regularity of the
heartbeat and can detect
arrhythmias.
- Holter monitor (ambulatory EKG/ECG). This test records the EKG
readings for a continuous 24-hour period. It can detect arrhythmias that occur
only rarely throughout the day. A small monitoring device is attached to
patches (electrodes) that are placed on the patient's chest. The device is
carried in a pouch around the neck or attached to a belt.
- Echocardiogram. This test uses sound waves to create a moving
picture of your heart. Echocardiogram provides information about the size and
shape of your heart and how well your heart chambers and valves are
functioning. The test also can identify areas of poor blood flow to the heart,
areas of heart muscle that are not contracting normally, and previous injury to
the heart muscle caused by poor blood flow.
- There are several different
types of echocardiograms, including a stress echocardiogram. During this test,
an echocardiogram is done both before and after your heart is stressed either
by having you exercise or by injecting a medicine into your bloodstream that
makes your heart beat faster and work harder. A stress echocardiogram is
usually done to find out if you have decreased blood flow to your heart (coronary
artery disease). Echocardiogram is a good way to diagnose hypertrophic
cardiomyopathy because it shows the thickened walls of the heart.
- Transesophageal (tranz-ih-sof-uh-JEE-ul)
echocardiography (TEE). In this test, the doctor inserts an ultrasound probe
into the throat after the patient is sedated. TEE provides a view of the back
of the heart.
- Stress Test. Some heart problems are easier to
diagnose when your heart is working harder and beating faster than when
its at rest. During stress testing, you exercise (or are given medicine
if you are unable to exercise) to make your heart work harder and beat faster
while heart tests are performed.
- During exercise stress testing,
your blood pressure and EKG readings are monitored while you walk or run on a
treadmill or pedal a bicycle. Other heart tests, such as nuclear heart scanning
or echocardiography, also can be done at the same time. These would be ordered
if your doctor needs more information than the exercise stress test can provide
about how well your heart is working.
- If you are unable to exercise, a
medicine can be injected through an intravenous line (IV) into your bloodstream
to make your heart work harder and beat faster, as if you are exercising on a
treadmill or bicycle. Nuclear heart scanning or echocardiography is then
usually done.
- During nuclear heart scanning,
radioactive tracer is injected into your bloodstream, and a special camera
shows the flow of blood through your heart and arteries. Echocardiography uses
sound waves to show blood flow through the chambers and valves of your heart
and to show the strength of your heart muscle.
- Your doctor also may order two
newer tests along with stress testing if more information is needed about how
well your heart works. These new tests are magnetic resonance imaging (MRI) and
positron emission tomography (PET) scanning of the heart. MRI shows detailed
images of the structures and beating of your heart, which may help your doctor
better assess if parts of your heart are weak or damaged. PET scanning shows
the level of chemical activity in different areas of your heart. This can help
your doctor determine if enough blood is flowing to the areas of your heart. A
PET scan can show decreased blood flow caused by disease or damaged muscles
that may not be detected by other scanning methods.
- Chest x ray. A chest x ray takes a picture of the organs and
structures inside the chest, including the heart, lungs, and blood vessels.
This test can show whether the heart is enlarged or whether fluid is building
up in the lungs.
- Blood tests, such as complete blood count, blood
chemistries, and cardiac enzymes. These tests are done to provide information
on the condition of the heart and to rule out other conditions.
The doctor may order additional tests to confirm the
diagnosis or if surgery is planned. These tests may include:
- Cardiac
catheterization. With this test doctors can check the pressure and blood
flow in the heart's chambers, collect blood samples from the heart, and examine
the arteries of the heart using x ray. A thin, flexible tube (catheter) is
passed through an artery in the upper thigh (groin) or in the arm to reach the
coronary arteries. This allows the doctor to study the inside of the arteries
to look for blockages.
- Coronary angiography. This test is usually performed along
with cardiac catheterization. Angiography enables the doctor to see the flow of
blood to the heart muscle. A dye that can be seen on an x ray image is injected
into the coronary arteries. Dye also can be injected into the chambers to
evaluate the pumping function of the heart.
- Myocardial biopsy. In this test, the doctor removes a piece of
heart muscle to look at under a microscope. The biopsy can be done during a
cardiac catheterization and is useful in diagnosing some types of
cardiomyopathy.
Because some types of cardiomyopathy run in
families, the doctor may recommend looking for the disease in the parents,
brothers and sisters, and children of people with cardiomyopathy.
Genetic counseling may be recommended. Genetic
counseling is useful to help define and explain how the disease runs in
families and to determine the chances of parents passing it on to their
children.
How Is Cardiomyopathy Treated?
Not everyone with cardiomyopathy needs treatment.
People who have no symptoms may not need treatment. In some cases, dilated
cardiomyopathy that comes on suddenly may even go away on its own. For other
people with cardiomyopathy, treatment is necessary.
Specific treatments depend on the type of
cardiomyopathy, how severe the symptoms and complications are, and the age and
overall health of the person.
Goals of Treatment
The main goals of treating cardiomyopathy are
to:
- Manage any conditions that cause or contribute to
the cardiomyopathy
- Control symptoms so that the person can live as
normally as possible
- Stop the disease from getting worse
- Reduce complications and the chance of sudden
cardiac death
Specific Types of Treatment
Treatments for cardiomyopathy may include medicines,
surgery, nonsurgical procedures, and lifestyle changes.
Medicines
A number of medicines may be used to treat
cardiomyopathy, including:
- Diuretics, which remove excess fluid and sodium
from the body.
- Angiotensin-converting enzyme (ACE) inhibitors,
which lower
blood
pressure and reduce stress on the heart.
- Beta-blockers, which slow the heart rate by
reducing the speed of the heart's contractions. These medicines also lower
blood pressure.
- Calcium channel blockers, which slow a rapid
heartbeat by reducing the force and rate of heart contractions. These medicines
also lower blood pressure.
- Digoxin, which increases the force of heart
contractions and slows the heartbeat.
- Anticoagulants, which prevent blood clots from
forming. Anticoagulants are often used in the treatment of dilated
cardiomyopathy.
- Antiarrhythmia medicines, which keep the heart
beating in a normal rhythm.
- Antibiotics, which are used before dental or
surgical procedures. Antibiotics help to prevent
endocarditis,
an infection of the heart walls, valves, and vessels.
- Corticosteroids, which reduce inflammation.
Surgery
Doctors can use several different types of surgery
to treat cardiomyopathy, including removing part of the enlarged heart muscle
(septal myectomy) and implanting devices that help the heart beat more
effectively. Heart transplant is sometimes used in cases of severe heart
failure.
Septal myectomy. Septal myectomy (also called
septal myomectomy) is open-heart surgery for people with hypertrophic
obstructive cardiomyopathy and severe symptoms. It is generally used in younger
patients and when medicines aren't working well.
In septal myectomy, a surgeon removes part of the
thickened septum that is bulging into the left ventricle. This widens the
pathway in the ventricle that leads to the aortic valve and improves blood flow
through the heart and out to the body. The tissue that is removed does not grow
back. If necessary, the mitral valve can be repaired or replaced at the same
time. This surgery is often successful, and the person can return to a normal
life with no symptoms.
Surgically implanted devices. Surgeons can
place several different types of devices in the heart to help it beat more
effectively. One device is a pacemaker, which electronically helps maintain
normal heart rhythm. Sometimes, doctors choose to use a biventricular
pacemaker, which coordinates contractions between the heart's left and right
ventricles.
A left ventricular assist device (LVAD) helps the
heart pump blood to the body. LVAD can be used as a long-term therapy or as a
short-term treatment for people who are waiting for a heart transplant.
An implantable cardioverter defibrillator (ICD) is
used in people who are at risk of life-threatening
arrhythmia or sudden cardiac death. This small device is
implanted in the chest and connected to the heart with wires. If the ICD senses
a dangerous change in heart rhythm, it will send an electric shock to the heart
to restore a normal heartbeat.
Heart transplant. In this surgery, a doctor
replaces a person's diseased heart with a healthy heart from a person who has
recently died. It is a last resort for people with heart failure when all other
treatments have failed.
Nonsurgical Procedure
Alcohol septal ablation. In this procedure, a
doctor injects ethanol (a type of alcohol) through a catheter into the small
artery that supplies blood to the thickened area of heart muscle. The alcohol
kills the cells and the thickened tissue shrinks to a more normal size. Blood
can flow freely through the pathway in the ventricle that leads to the aortic
valve, and symptoms improve.
Lifestyle Changes
The doctor may recommend lifestyle changes to manage
a condition that is causing the cardiomyopathy. These changes may help reduce
symptoms. Lifestyle changes may include:
- Quitting smoking
- Losing excess weight
- Eating a low-salt diet
- Getting moderate exercise, such as walking, and
avoiding strenuous exercise
- Avoiding the use of alcohol and illegal
drugs
- Getting enough sleep and rest
- Reducing stress
- Treating underlying conditions, such as diabetes
and high
blood pressure
How Can Cardiomyopathy Be Prevented?
People can make lifestyle choices to reduce the risk
of conditions that may lead to cardiomyopathy, such as
coronary
artery disease,
high
blood pressure, and
heart
attack. Examples of lifestyle choices include:
- Quitting smoking
- Eating a healthy diet and maintaining a healthy
weight
- Getting regular physical exercise
- Avoiding the use of alcohol and illegal
drugs
People also can control high blood pressure,
high
blood cholesterol, and diabetes by:
- Getting regular checkups with their doctors
- Following their doctors' advice about lifestyle
changes
- Taking medicines as directed
Some types of cardiomyopathy, such as inherited
forms, can't be prevented. Restrictive cardiomyopathy can't always be prevented
because it occurs as the result of another disease. Sometimes, underlying
diseases can be prevented or treated early enough to stop restrictive
cardiomyopathy from developing.
It may be possible to prevent sudden cardiac death
if doctors can identify a person at high risk of this event and treat him or
her with an implantable cardioverter defibrillator.
Living With Cardiomyopathy
Some peopleespecially those with hypertrophic
cardiomyopathymay live a healthy life with few problems or symptoms.
Others may have serious symptoms and complications. Very rarely, cardiomyopathy
can cause sudden death in young people.
Here are some things you can do if you have
cardiomyopathy:
- Take all of your medicines as your doctor
prescribes.
- Make all of the lifestyle changes recommended by
your doctor.
- Go to all of your medical appointments.
You may need to take antibiotics before seeing the
dentist or having certain medical procedures. This is important because it can
prevent an infection in your heart (endocarditis).
Ongoing Health Care Needs
You should talk to your doctor if you notice new or
worse symptoms, such as swelling in your legs or feet. These could be a sign
that your condition is getting worse.
You also should talk with your doctor to find out
how much exercise is right for you. People with hypertrophic cardiomyopathy
should not exercise vigorously, but moderate exercise, such as walking, is
often a good idea.
Your doctor can help you decide what kind of diet is
right for you. Doctors will often recommend that people with hypertrophic
cardiomyopathy drink lots of water and other fluids. Your doctor also may
suggest a diet low in salt and fat.
Cardiomyopathy often runs in families. Your doctor
may suggest that your parents, brothers and sisters, and children get checked
every once in a while to see whether they have cardiomyopathy.
Support Groups
The
Children's Cardiomyopathy Foundation provides support and
information to parents of children with cardiomyopathy.
Long-Term Care, Hospice, End-of-Life Issues
Cardiomyopathy can have serious complications, such
as heart
failure, serious
arrhythmias, or sudden cardiac death. It is important that you
discuss these possibilities with your family and your doctor and prepare for
them.
Advance directives are documents that tell doctors
and hospitals what treatment you want or do not want if you are too ill to
speak for yourself. If you have a serious condition for which there is no cure,
you may decide that you only want treatment to make you comfortable. You may or
may not want treatment if your heart or breathing stops. Advance directives are
a way for you to record your wishes about such treatment ahead of time.
As long as you are able to make your own decisions,
your advance directive will not be used, and you can accept or refuse any
medical treatment. But if you become seriously ill, you may not be able to make
decisions about your own treatment.
Two types of advance directives include a living
will and a medical power of attorney. A living will provides directions and
instructions about your health care preferences. A medical power of attorney
names a person you trust to speak for you when you are unable to make
decisions.
Advance directives are easy to prepare. You can do
it yourself without a lawyer, as long as you are 18 years or older. You may
prepare your advance directive by:
- Simply writing down your wishes
- Completing a form that your doctor, the hospital,
or the health department may have
- Using a special computer software program for
legal documents
- Going to a lawyer
Depending on the State where you live, the document
also may need to be witnessed by one or two people or notarized.
Give a copy of your living will and/or medical power
of attorney to a family member and keep another copy in a safe place. People
with severe heart failure are in the hospital often. It is important that you
or a family member bring copies of advance directive documents every time you
go to the hospital.
Hospice Care
If you have heart failure that gets worse over time,
your treatments may eventually stop working. If you and your doctor agree that
your treatments are not working, hospice care may be an option. Hospice is an
organization that can comfort and support you and your family. A team of people
provides hospice care. This team includes doctors, nurses, social workers,
nurses' aides, chaplains, and volunteers.
The goals of hospice care are to provide:
- Comfort rather than cures
- Emotional support to you and your family
- Care that supports dying with dignity
- Spiritual support as requested by you and your
family
Hospice supports life and views dying as a natural
process. Hospice will work with you and your family to provide the services you
need.
Research
If you are diagnosed with cardiomyopathy, you should
ask your doctor about any research studies available that you may be eligible
to enroll in. Research studies often provide focused attention on questions
about diagnosis and treatment. The researchers conducting studies are generally
experts in the field, and they may assist you and your doctor, while also
gaining information that could be helpful to other patients with
cardiomyopathy.
Key Points
- Cardiomyopathy refers to diseases of the heart
muscle. It has a variety of causes, symptoms, and treatments.
- In cardiomyopathy, the heart muscle becomes
enlarged or abnormally thick or rigid. In rare cases, the muscle tissue in the
heart is replaced with scar tissue.
- The four major types of cardiomyopathy are
dilated, hypertrophic, and restrictive cardiomyopathy and arrhythmogenic right
ventricular dysplasia.
- Some types of cardiomyopathy are caused by a gene
mutation and run in families. Other types are a result of another disease or
condition, such as damage to the heart from a
heart
attack,
high
blood pressure, or a viral infection. In many cases, the cause is
unknown.
- Cardiomyopathy can affect people of all ages,
from babies to older adults. However, certain age groups are more likely to
have certain types of cardiomyopathy.
- Signs and symptoms of cardiomyopathy can include:
- Tiredness
- Weakness
- Shortness of breath after exercise or even at
rest
- Swelling of the abdomen, legs, ankles, and
feet
- Dizziness, lightheadedness, or fainting
during exercise
- Abnormal heart rhythms (arrhythmias) or an extra or unusual sound heard during the
heartbeat (heart
murmur)
- Cardiomyopathy is diagnosed using a medical
history, physical exam, and tests such as
chest x ray,
electrocardiogram,
echocardiogram, stress test, and blood tests.
- Because cardiomyopathy often runs in families,
doctors may recommend that the parents, brothers and sisters, and children of
people with cardiomyopathy be tested for the disease.
- Treatments depend on the type of cardiomyopathy,
how severe the symptoms and complications are, and the age and overall health
of the person.
- The main goals of treatment are to manage any
conditions that cause or contribute to the cardiomyopathy, control symptoms,
stop the disease from getting worse, and reduce complications and the chance of
sudden cardiac death.
- Treatment may involve medicines, surgery,
nonsurgical procedures, or lifestyle changes.
- Cardiomyopathy can sometimes be prevented by
managing or preventing the underlying condition that causes the disease.
Cardiomyopathy that runs in families cannot be prevented.
- Some people live long, healthy lives despite
having cardiomyopathy. Some people don't even realize that they have the
disease because they have no symptoms. In other people, the disease develops
rapidly, symptoms are severe, and serious complications develop. Current
treatments can do much to reduce symptoms and help people live healthy
lives.
Links to Other Information About
Cardiomyopathy
NHLBI Resources
Non-NHLBI Resources
Clinical Trials
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