What does it mean for your heart?
You’re at the doctor’s because lately you’ve been feeling increasingly tired, and it frequently feels like your heart is pounding in your chest. The doctor is concerned that you might have cardiomyopathy and sends you for a bunch of tests. What is this? Should you be worried? Can it be corrected?
Cardiomyopathy is when your heart doesn’t function as well as it should due to disease or damage. Unfortunately, the cause is often unknown. Many things contribute to the possibility of developing it. These risk factors include having long-term high blood pressure, heart tissue damage from a heart attack, chronic rapid heart rate, heart valve problems, metabolic disorders (ex. thyroid disease or diabetes), nutritional deficiencies of essential vitamins/minerals, pregnancy complications, too much alcohol over many years, certain drugs, chemotherapy/radiation treatments, certain infections, hemochromatosis (iron buildup in the heart muscle), sarcoidosis (inflammation and lumps of cells growing in the heart and other organs), amyloidosis (buildup of abnormal proteins in the body), connective tissue disorders, and infection with COVID-19.
There are three main types of cardiomyopathy: dilated, hypertrophic, and restrictive. In dilated, the main chamber of your heart (left ventricle) doesn’t pump effectively because it’s enlarged (dilated). This form is most common, and it usually affects men and those who are middle-aged. The precipitating factor is typically coronary artery disease or heart attack. For hypertrophic, the left ventricle muscle becomes thickened, making it harder for your heart to work properly. This kind is linked to a family history of the disorder, so it’s thought to be a genetic mutation. It can occur at any age, but it’s generally more severe if diagnosed during childhood. With restrictive, the heart muscle is rigid and not as elastic as usual, hindering the heart’s ability to expand and fill with blood. This form is uncommon and generally happens to older individuals. Typically, it’s the result of an unknown cause or a disease elsewhere in the body affecting the heart. A rare category of cardiomyopathy is arrhythmogenic right ventricular dysplasia. This is from a genetic mutation causing the right ventricle’s muscle to be replaced by scar tissue resulting in heart rhythm problems. If a person has cardiomyopathy, but it can’t be sorted into the previously mentioned groups, it’s called unclassified.
Cardiomyopathy symptoms are breathlessness with exertion/rest, swelling of legs/ankles/feet, bloating of the abdomen from fluid buildup, cough when lying down, fatigue, rapid/pounding/fluttering heartbeats, chest pressure/discomfort, and dizziness/lightheadedness/fainting. If not treated, symptoms will worsen. For some individuals, this occurs rapidly, but for others, it takes a long time. Cardiomyopathy can lead to several dangerous complications, such as heart failure, blood clots, valve problems, and sudden cardiac arrest/death.
The treatment for cardiomyopathy depends on the type you have. However, the goals are the same: to manage symptoms, reduce complication risk, and prevent your condition from deteriorating. There are several options to achieve this, such as medications, implanted devices, non-surgical procedures, and surgery. Medications are used to improve the heart’s pumping ability, improve blood flow, lower blood pressure, slow heart rate, remove excess fluid from the body, or keep blood clots from forming. None of these will get rid of cardiomyopathy. Instead, they help to enhance heart function and manage symptoms. Some implantable devices do this as well. Pacemakers are small devices placed under the skin and use electrical impulses to control your heart’s rhythm. Implantable cardioverter-defibrillator (ICD) monitor your heart’s rhythm and delivers electric shocks when needed to control abnormal heart rhythms. A ventricular assist device (VAD) helps blood circulate through your heart. It’s considered after less-invasive approaches are unsuccessful and can be used as a long-term treatment or short-term treatment while waiting for a heart transplant.
When it comes to non-surgical and surgical procedures, there are two options for each. With a septal ablation, a small portion of the thickened heart muscle is destroyed by injecting alcohol through a catheter into the artery supplying blood to that area. Radiofrequency ablations are used to treat abnormal heart rhythms. During this procedure, doctors guide catheters through your blood vessels to your heart, where electrodes at the catheter tips transmit energy to damage the small spot of heart tissue that is causing the abnormal heart rhythm. A septal myectomy is open-heart surgery, where part of the thickened heart muscle wall (septum) that separates the ventricles is removed, allowing better blood flow. The other surgical option is a heart transplant. You might need this if medications and other treatments are no longer effective and you have end-stage heart failure.
While you might not be able to prevent cardiomyopathy completely, there are things you can do to reduce your chances of developing the disorder. The main goal is to live a heart-healthy lifestyle by making good choices. The number one thing is eating a nutritious diet that contains a variety of fruits, vegetables, and whole grains. You should limit your salt intake and minimize the amount of alcohol you consume. Another critical element is to get moderate exercise daily. If you’re overweight or haven’t been working out for a while, talk to your doctor before beginning any new routine. Two other vital factors are getting enough sleep each night and reducing your overall stress. Avoid smoking and using illegal drugs. By doing all of these things, you’ll have a better chance at controlling your weight, blood pressure, and cholesterol levels, which will decrease the probability of having diabetes and obesity (two significant risk factors of heart problems).
Cardiomyopathy is a serious condition, but with the right treatment, you can manage it successfully. The best way to avoid it is to do everything possible to prevent it. If you have any questions or concerns about cardiomyopathy, please speak with your doctor. If you would like more information, please visit the American Heart Association’s Cardiomyopathy page at https://www.heart.org/en/health-topics/cardiomyopathy