A disease, which causes structural and functional idiopathic myocardial damage is called cardiomyopathy. At first, cardiomyopathy symptoms may be mild. Cardiomyopathy treatment depends on the type of disease, as every type of cardiomyopathy (dilated, hypertrophic, restricted, etc) has specific features. Below you may read in detail how is performed diagnostics of cardiomyopathy, as well as what are the available newest treatment options for this condition.
Cardiomyopathy refers to diseases of the heart muscle. Cardiomyopathy causes the heart muscle to become enlarged, thick or rigid. In rare cases, the muscle tissue in the heart is replaced with scar tissue.
As the condition worsens, the heart becomes weaker making it harder to pump blood through the body as well as to maintain a normal electrical rhythm. This will result in heart failure or irregular heartbeats called arrhythmias. Heart failure can cause fluid to build up in the lungs, ankles, feet, legs, or abdomen.
A weakened heart can also cause other complications such as heart valve problems.
What are the different types of Cardiomyopathy?
The different types of inherited cardiomyopathy are:
- Hypertrophic cardiomyopathy (HCM or HOCM)
- Dilated cardiomyopathy(DCM)
- Restricted cardiomyopathy
- Arrhythmogenic right ventricular cardiomyopathy(ARVC)
Takotsubo cardiomyopathy is another type of Cardiomyopathy that can cause extreme stress. This is not inherited and normally disappears with time.
People with cardiomyopathy may not experience any signs and symptoms in the early stages. However, as the condition develops, signs and symptoms may appear. They include:
- Breathlessness with exertion or even at rest
- Swelling of the legs, ankles and feet
- Bloating of the abdomen (fluid build-up)
- Cough while lying down
- Irregular heartbeats that feel rapid, pounding or fluttering
- Chest pain
- Dizziness, light-headedness and fainting
Cardiomyopathy symptoms and signs tend to get worse in all types of the condition unless treated. For some, this worsening happens quickly, while in others, it may not worsen for a long time.
CARDIOMYOPATHY TREATMENT OPTIONS
Cardiomyopathy is treatable and the type of treatment you’ll receive depends largely on which type of cardiomyopathy you have and how severe it is.
The overall goals of cardiomyopathy treatment are to manage your signs and symptoms, prevent your condition from worsening, and to reduce your risk of complications. Treatment optinos vary depending on which major type of cardiomyopathy you have.
Dilated cardiomyopathy treatment
If you’re diagnosed with dilated cardiomyopathy, your doctor may recommend treatment including:
- Mediation: Your doctor may prescribe medications to improve your heart’s pumping ability and function, improve blood flow, lower blood pressure, slow your heart rate, remove excess fluid from your body or to prevent blood clots from forming.
- Surgically implanted devices: If you’re at risk of serious heart rhythm problems, your doctor may recommend an implantable cardioverter-defibrillator (ICD) — a device that monitors your hearts’ rhythm and delivers electric shocks when necessary to control abnormal heart rhythms.
In some cases, your doctor may recommend a pacemaker that coordinates the contractions between the left and right ventricles (biventricular pacemaker).
Hypertrophic cardiomyopathy treatment
If you’re diagnosed with hypertrophic cardiomyopathy, your doctor may suggest several treatments, including:
- Medication: Your doctor may prescribe medications that relax your heart, slow its pumping action and stabilize its rhythm.
- Implantable cardioverter-defibrillator (ICD): If you’re at high risk of serious heart rhythm problems, your doctor may suggest an ICD to monitor your heart rhythm and deliver electric shocks when needed to control abnormal heart rhythms.
- Septal myectomy: In a septal myectomy, your surgeon will remove part of the thickened heart muscle wall (septum) that separates the two bottom heart chambers (ventricles). Removing this part of the heart muscle improves blood flow through the heart and reduces mitral valve regurgitation.
- Septal ablation: In septal ablation, a small section of the thickened heart muscle is destroyed by injecting alcohol through a long, thin tube (catheter) into the artery that supplies blood to the area.
Restrictive cardiomyopathy treatment
The focus of treating cardiomyopathy is on improving symptoms and your doctor will recommend you pay careful attention to your salt and water intake plus monitoring your weight daily. Your doctor may also recommend you take diuretics if sodium and water retention becomes an issue. Your doctor may prescribe you medications to lower your blood pressure or control abnormal heart rhythms.
If the cause of your restrictive cardiomyopathy is found, treatment will also be directed at the underlying disease, for example, amyloidosis.
Many of the medications that doctors prescribe for cardiomyopathy may come with a number of side effects. Ensure you discuss these possible side effects with your doctor before taking any of these drugs.
Arrhythmogenic right ventricular dysplasia
If you have arrhythmogenic right ventricular dysplasia, your doctor may suggest treatment such as:
- Implantable cardioverter-defibrillator (ICD): If you’re at a high risk of dangerous heart rhythms, your doctor may recommend an ICD. An ICD monitors your heart rhythm and delivers electric shocks when necessary in order to control abnormal heart rhythms. If an ICD isn’t appropriate in your situation, or if you have an ICD and have frequent fast heart rhythms, your doctor may prescribe medications to help regulate your heart rhythm.
- Radiofrequency ablation: If other treatments aren’t working to control your abnormal heart rhythms, your doctor may recommend radiofrequency ablation.
This procedure involves doctors guiding long, flexible tubes (catheters) through your blood vessels to your heart. Electrodes at the catheter tips transmit energy in order to damage a small spot of the affected heart tissue that is causing the abnormal heart rhythm.
Ventricular assist devices (VADs)
Ventricular assist devices (VADs) can help blood circulate through your heart. They usually are considered if less invasive approaches are unsuccessful. These devices can be suitable as a long-term treatment or as a short-term treatment while waiting for a heart transplant.
- History taking and physical examination: During a physical examination your doctor will ask your personal and family medical history, and ask when your symptoms occur — for example, whether exercise brings on your symptoms. If your doctor thinks you have cardiomyopathy, you may need to undergo further testing to confirm the diagnosis.
- Chest X-ray: An image of your heart shows whether it’s enlarged or not.
- Echocardiogram: An echocardiogram uses sound waves to produce images of the heart. Your doctor can use these images to examine the size and function of your heart. This test checks your heart valves and helps your doctor determine the cause of your symptoms.
- Electrocardiogram (ECG): In this noninvasive test, electrode patches are attached to your skin to measure electrical impulses from your heart. An ECG can show disturbances in the electrical activity of your heart, which can detect abnormal heart rhythms and areas of injury.
- Treadmill stress test: Your heart rhythm, blood pressure and breathing are monitored while you walk on a treadmill. Your doctor may recommend a treadmill stress test to evaluate symptoms, determine your exercise capacity and determine if exercise causes abnormal heart rhythms to occur.
- Cardiac catheterization: In this procedure, a thin tube (catheter) is inserted in your groin and threaded through your blood vessels to your heart. Doctors may extract a small sample (biopsy) of your heart for analysis in the laboratory. Pressure within the chambers of your heart can be measured to see how strongly blood pumps through your heart. Doctors may inject a dye into your blood vessels to help your blood vessels show up better on X-rays (coronary angiogram). This test may be used to ensure that your blood vessels do not have any blockages.
- Cardiac magnetic resonance imaging (MRI): Cardiac MRI is an imaging technique that uses radio waves and magnetic fields to create images of your heart. Cardiac MRI may be used in addition to echocardiography, particularly if the images from your echocardiogram aren’t effective in making a diagnosis.
- Cardiac computerized tomography (CT) scan: In a cardiac CT scan, you lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest. This test may occasionally be conducted to assess the size and function of your heart and heart valves.
- Blood tests: Several blood tests may be performed, including those to check your kidney, thyroid and liver function, and to measure your body’s iron levels. One blood test can measure B-type natriuretic peptide (BNP), a protein produced in your heart. Your blood level of BNP rises when your heart is subjected to the stress of heart failure; a common complication of cardiomyopathy.
- Genetic testing or screening: Cardiomyopathy can sometimes be hereditary. Ensure you discuss with your doctor whether genetic testing may be an appropriate option for you and your family. Your doctor may recommend family screening or genetic testing for your first-degree relatives (parents, children and siblings).