Cardiomyopathy

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Overview

Cardiomyopathy is an anatomic and pathologic diagnosis associated with muscle or electrical dysfunction of the heart. Cardiomyopathies represent a heterogeneous group of diseases that often lead to progressive heart failure with signifcant morbidity and mortality. Cardiomyopathies may be primary (i.e., genetic, mixed, or acquired) or secondary (e.g., infltrative, toxic, infammatory). Major types include dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, and arrhythmogenic right ventricular cardiomyopathy. Although cardiomyopathy is asymptomatic in the early stages, symptoms are the same as those characteristically seen in any type of heart failure and may include shortness of breath, fatigue, cough, orthopnea, paroxysmal nocturnal dyspnea, and edema. Diagnostic studies include B-type natriuretic peptide levels, baseline serum chemistries, electrocardiography, and echocardiography. Treatment is targeted at relieving the symptoms of heart failure and reducing rates of heart failure–related hospitalization and mortality. Treatment options include pharmacotherapy, implantable cardioverter-defbrillators, cardiac resynchronization therapy, and heart transplantation. Recommended lifestyle changes include restricting alcohol consumption, losing weight, exercising, quitting smoking, and eating a low-sodium diet.

Symptoms

Symptoms

Breathlessness with activity or even at rest.

Swelling of the legs, ankles and feet.

Bloating of the abdomen due to fluid buildup.

Cough while lying down.

Difficulty lying flat to sleep.

Fatigue.

Heartbeats that feel rapid, pounding or fluttering.

Chest discomfort or pressure.

Causes

According to the National Heart, Lung, and Blood InstituteTrusted Source, the cause of cardiomyopathy is often unknown. In other cases, the cause can either be inherited or acquired:


“Inherited” means that you‘re born with cardiomyopathy due to the genes you inherited from your parents.

“Acquired” means that you developed cardiomyopathy due to a health condition, disease, or some other type of illness during the course of your life, such as:

coronary artery disease

heart tissue damage due to a heart attack

infections in the heart muscle


Risk factors

Cardiomyopathy can affect people of all ages. Major risk factors include:


a family history of cardiomyopathy, sudden cardiac arrest, or heart failure

coronary artery disease

chronic (long-term) high blood pressure

damage to the heart due to a heart attack

infections that cause inflammation of the heart

heart valve disorders

COVID-19 infection

diabetes

obesity

thyroid disease

alcohol use disorder

sarcoidosis

hemochromatosis

amyloidosis

connective tissue disorders

use of cocaine or amphetamines

some types of cancer medications

exposure to toxins, such as poison or heavy metals


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Complications

This can cause blood to flow backward in the valve. Cardiac arrest and sudden death. Cardiomyopathy can trigger irregular heart rhythms that cause fainting or, in some cases, sudden death if the heart stops beating effectively.

Cardiomyopathy can lead to serious complications, including:


Heart failure. The heart can't pump enough blood to meet the body's needs. Untreated, heart failure can be life-threatening.

Blood clots. Because the heart can't pump effectively, blood clots might form in the heart. If clots enter the bloodstream, they can block the blood flow to other organs, including the heart and brain.

Heart valve problems. Because cardiomyopathy causes the heart to enlarge, the heart valves might not close properly. This can cause blood to flow backward in the valve.

Cardiac arrest and sudden death. Cardiomyopathy can trigger irregular heart rhythms that cause fainting or, in some cases, sudden death if the heart stops beating effectively.


Prevention

In many cases, there's no prevention for cardiomyopathy. Let your health care provider know if you have a family history of the condition.


You can help reduce your risk of cardiomyopathy and other types of heart disease by living a heart-healthy lifestyle, including:


Avoiding the use of alcohol or cocaine

Controlling high blood pressure, high cholesterol and diabetes

Eating a healthy diet

Getting regular exercise

Getting enough sleep

Reducing your stress