What Is Cardiomyopathy?

Cardiomyopathy refers to several types of heart muscle damage. Early detection is important because cardiomyopathy can sometimes be life-threatening.

Your heart muscle works constantly to pump blood to the rest of your body. So, it’s no surprise that damage to normal cardiac muscle can cause serious and even life-threatening consequences. Cardiomyopathy is the medical term that describes this health problem.

To understand cardiomyopathy, it’s important to recognize this is not one single disease. Instead, it describes several conditions with multiple causes.

Cardiopathy can cause the heart muscle to stiffen, thin or thicken, or fill with substances from other parts of the body that are normally foreign to the heart muscle. When this damage occurs, your heart has to work harder to pump blood to the rest of your body. That can lead to heart failure, irregular heart rhythms, blood backing up into the lungs, damaged heart valves, and other serious problems.

Cardiomyopathy is not uncommon. Men and women of all ages can develop cardiomyopathy. In fact, the Centers for Disease Control and Prevention (CDC) notes as many as one in 500 U.S. adults may have the condition. Although rare, children can have cardiopathy, too.

While some cases can be mild, others can be serious and even deadly. That’s why it’s important to understand early signs and symptoms of cardiomyopathy so medical care can be initiated, if needed, as early as possible.

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What causes cardiomyopathy?

Cardiomyopathy can be primary, which means muscle cells in the heart are abnormal, usually because of an inherited genetic defect. The condition can also be secondary, meaning other conditions have damaged healthy heart muscle cells.

The causes of cardiomyopathy are not always identified. Some are very rare. The CDC explains, however, that cardiomyopathy is most often linked to these conditions, diseases, or inherited risks:

• A family history of cardiomyopathy, sudden cardiac arrest or heart failure
• Diseases that may cause heart damage, including hemochromatosis (also called “iron overload,” a condition in which iron accumulates in organs), sarcoidosis (an inflammatory disease that produces nodules throughout the body) or amyloidosis (a disease causing an abnormal protein to build up in organs)
• Coronary heart disease or heart attack
• Long-term alcoholism or cocaine abuse
• Autoimmune diseases that affect connective tissue
• Endocrine diseases, including thyroid conditions and diabetes
• Myocarditis (heart muscle infection)
• Muscular dystrophy

Types of cardiomyopathy and symptoms

Although signs of cardiomyopathy can vary according to the cause and severity of the condition, people with cardiomyopathy usually experience some or all of these symptoms:

• Shortness of breath
• Fatigue
• Irregular heartbeats
• Swelling in the ankles, legs and abdomen
• Sometimes syncope (fainting)

Dilated cardiomyopathy is the most common type. It’s diagnosed in adults between the ages of 20 and 60, according to the CDC. Although cardiomyopathy is relatively rare in children, the dilated type is the form most often diagnosed when youngsters do have the condition. It can be inherited or due to other causes.

Dilated cardiomyopathy affects both the lower and upper chambers of the heart, causing them to dilate. The result, over time, is that the heart pumps blood less effectively than normal. Eventually, dilated cardiomyopathy can cause heart failure, heart valve problems, irregular heartbeats (arrhythmias), and blood clots in the heart.

Hypertrophic cardiomyopathy (HCM) is primarily the result of a genetic abnormality that causes the walls of the lower heart chamber (the left ventricle) to become thick and stiff, reducing the heart’s ability to beat normally. As HCM progresses, it can cause other health problems, including atrial fibrillation (a heart rhythm abnormality that can lead to blood clots), stroke, heart failure, and other complications.

Although rare, HCM can lead to sudden cardiac arrest. In fact, the condition is cited as the most common cause of sudden cardiac death in young people and athletes under the age of 35, the American Heart Association reports.

If there is a family history of this condition or unexplained sudden deaths in children or young people in the family, it’s important for family members to undergo testing for HCM.

For people with the condition who don’t have symptoms, a healthy lifestyle and medical monitoring may be all that’s required. HCM is a chronic condition that can get worse over time, so regular check-ups and reporting any new symptoms to your doctor are important.

Arrhythmogenic right ventricular dysplasia (ARVD) is another rare type of cardiomyopathy; it’s often inherited and more likely to affect males. ARVD occurs when heart muscle tissue in the right lower ventricle dies and is replaced with scar tissue, disrupting the heart’s normal electrical signals. Resulting symptoms include irregular heartbeats and fainting after exercise. ARVD is found most often in teens or young adults and can cause sudden cardiac arrest. That’s why adolescents and young men with fainting episodes after physical activity should be tested for the condition.

Restrictive cardiomyopathy is another rare type of cardiomyopathy, primarily found in older adults. It occurs when the lower heart chambers become rigid due to normal heart muscle being replaced by abnormal tissue, such as scar tissue. The upper chambers (the atria) become enlarged, and heart failure and arrhythmias can result.

Although not common, cardiomyopathy can sometimes develop when a woman is in the last months of pregnancy, or up to five months after giving birth. Peripartum cardiomyopathy (PPCM) may be caused by underlying heart problems (such as damage from a previous heart infection), or the cause may be unknown. Treatment depends on the severity of damage to the heart muscle.

Another form of unusual cardiomyopathy, known as broken heart syndrome, is the result of extreme stress, such as the death of a spouse or child. The severe reaction of the body to the stressful event can cause one of the heart’s lower chambers to balloon outward, potentially causing heart failure and irregular heart rhythms. The good news is this form of cardiomyopathy may resolve over time when stress lessens.

Early diagnosis and treatment is important

People who have cardiomyopathy with no or mild symptoms may need little treatment or even none. Sometimes, dilated cardiomyopathy may even go away on its own. All forms of cardiomyopathy, however, may progress, sometimes suddenly. That’s why following a healthy lifestyle and being monitored regularly by your doctor is important if you are diagnosed with cardiomyopathy, even if you are symptom-free.

Treatment methods include:

• Heart-healthy lifestyle changes, including diet and exercise, quitting smoking, losing weight, avoiding alcohol, reducing stress, and getting enough sleep
• Medicines, such as angiotensin-converting enzyme (ACE) inhibitors, beta blockers, and calcium channel blockers

The goal of treatment is to slow down progression of the condition, control symptoms, and prevent sudden death, the CDC explains. Depending on the type and severity of the condition, surgery, pacemakers and, in severe cases, heart transplants may be warranted.

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