Cardiomyopathy overview
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Cardiomyopathy Microchapters |
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Diagnosis |
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Treatment |
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Guidelines |
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2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy |
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Case Studies |
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Cardiomyopathy overview On the Web |
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American Roentgen Ray Society Images of Cardiomyopathy overview |
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Risk calculators and risk factors for Cardiomyopathy overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Edzel Lorraine Co, DMD, MD[2]
Overview
Cardiomyopathy refers to diseases that involve the heart muscle and leads to its abnormal function and/or structure, in the absence of coronary artery disease, hypertension, valvular disease or congenital heart disease that would explain the myocardium dysfunction.
Classification
Cardiomyopathies can generally be categorized into two groups (based on World Health Organization guidelines): extrinsic cardiomyopathies and intrinsic cardiomyopathies [1]. Cardiomyopathy can also be classified from a clinical standpoint, as to whether it is restrictive, dilated, or hypertrophic.
Causes
There is a very wide range of factors that can cause cardiomyopathy, ranging from infectious causes, toxins, genetic causes and other disease processes.
Risk Factors
Some of the risk factors for developing cardiomyopathy include: a family history of cardiomyopathy, heart failure or sudden death, a history of other diseases that may lead to cardiomyopathy, obesity, alcoholism, and long standing high blood pressure. Certain diseases such as hemochromatosis, amyloidosis, and sarcoidosis also increase the risk of developing cardiomyopathy.
Natural History, Complications and Prognosis
Cardiomyopathy will continue to progressively worsen, unless intervened on. Complications and sequelae of cardiomyopathy include heart failure, arrythmia, thromboembolic disease, and sudden cardiac death.
Diagnosis
History and Symptoms
Patients may be asymptomatic in early stages of disease. When symptoms occur, they include: shortness of breath, edema of the lower extremities, fatigue, loss of consciousness, and palpitations due to arrythmias.
Physical Examination
A thorough physical examination can help in diagnosing cardiomyopathy. Particular attention should be given to the cardiac exam, the lung exam, the extremities for edema, and in assessing for other signs of heart failure such as jugular venous distension.
Chest X Ray
A chest x ray also shows fluid build-up, or a pleural effusion in the lungs, which can be a sign of the complication of heart failure.
Treatment
Medical Therapy
Treatment depends on the type of cardiomyopathy, but may include medication, implanted pacemakers, defribillators, or ventricular assist devices (LVADs), or ablation. The goal of treatment is often symptom relief, and some patients may eventually require a heart transplant. Treatment of cardiomyopathy (and other heart diseases) using alternative methods such as stem cell therapy is commercially available but is not supported by convincing evidence.
Surgery
There are several types of surgery used to treat cardiomyopathy. They include septal ablation, septal myectomy, surgically implanted devices to improve the function of the heart, and heart transplant.
Primary Prevention
Methods of primary prevention for cardiomyopathy include; maintaining a healthy weight, not smoking, avoiding alcohol and illicit drugs, reducing stress, and treating underlying conditions such as diabetes and high blood pressure.