Cardiomyopathy

WHAT YOU SHOULD KNOW

Translated literally, “cardiomyopathy” means “disease of the heart muscle.” In practical terms, it generally means a decline in the heart's pumping power. It can result from an inflammation of the muscle tissue, stiffening of the tissue, or a loss of muscle fibers. The disease can come on by itself ( primary cardiomyopathy) or develop as part of a more widespread problem (secondary cardiomyopathy).

Causes

Frequently, cardiomyopathy is a result of damage done to the heart by a heart attack, coronary artery disease, infection, cancer, a connective tissue disorder, or certain drugs, nutritional deficiencies, and metabolic disorders. Alcohol is often part of the problem, both as a toxin in itself, and as a cause of malnutrition. Whatever the cause, the walls of the heart's pumping chambers expand and weaken. This most common form of the disorder is known as dilated congestive cardiomyopathy.

Another form of the problem, marked by excessive bulking and stiffening of the heart muscle, is called hypertrophic cardiomyopathy. Here, the walls of the pumping chambers swell and constrict the space available for blood, resulting in a decline in throughput. The problem can result from a narrowing or stiffening of the main artery leading from the heart, from high blood pressure, or from an inherited defect. The least common form of cardiomyopathy is referred to as restrictive cardiomyopathy. It is marked by chamber walls so stiff that the heart cannot expand sufficiently between beats to fill with the normal amount of blood. The cause of this type of cardiomyopathy is usually unknown, although it sometimes results from too much iron accumulating in the heart muscle or invasion of the heart tissue by a tumor.

Signs/Symptoms

The typical signs of cardiomyopathy are fatigue, shortness of breath, dizziness, chest pain, abnormal heart rhythm, and swollen ankles.

Care

Treatment depends upon the cause. Drugs that lower blood pressure and boost heart function are often prescribed for the congestive and hypertrophic forms of the disease. Water pills (diuretics) are given to reduce water retention and swelling. If the condition is the result of a bacterial infection, antibiotics will be prescribed. If it's caused by alcohol, drugs, or other toxins, it can be reversed by eliminating the culprit. In some severe cases, a heart transplant may be the only effective means of treatment.

Risks

Although some cases of cardiomyopathy can be controlled with medication or even reversed, the outlook is often poor. Even with proper care, the condition usually gets worse, leading to congestive heart failure and abnormal heart rhythms that can trigger sudden death.

WHAT YOU SHOULD KNOW

• Medicines for this condition are often complicated, but vitally important. Be sure to take them faithfully.
• If you have other illnesses, such as diabetes or high blood pressure, you need to get them under control. These disorders put you at a higher risk of heart problems.
• Ensure that all healthcare providers are aware of your condition. You will need antibiotic treatment prior to any dental or surgical procedures.
• Exercise to the full extent your doctor recommends. Regular exercise strengthens the heart and lowers blood pressure.
• Eat a well balanced diet low in fat, salt, and cholesterol.
• Maintain a healthy weight. Too much weight can put added stress on your heart.
• Learn to control stress by adopting new ways to relax such as deep breathing exercises, muscle relaxing techniques, meditation, or yoga.
• Get at least seven hours of sleep each night and nap during the day if you feel tired.
• Quit smoking. If you are having trouble quitting, ask your doctor for help or for additional resources that can assist you.
• If your condition is directly related to alcohol, you must stop drinking completely. If necessary, ask your doctor for help. Otherwise, limit alcohol consumption to no more than one drink per day.
• For more information, contact the American Heart Association at 1-800-AHA-USA1 (242-8721) or 214-373-6300 or visit their website at www.americanheart.org.

Call Your Doctor If...

• You become light-headed, dizzy, sweaty, or nauseated.
• You gain several pounds in one or two days.
• You have trouble breathing.
• You experience chest pain during exercise that doesn't go away with rest.
• Your pulse is faster or slower than usual.
• You begin wheezing (a high pitched noise when breathing in or out).

Seek Care Immediately If...

• You develop breathing difficulties.
• You develop a fast or uneven heartbeat.

IF YOU'RE HEADING FOR THE HOSPITAL...

What to Expect While You're There

You may encounter the following procedures and equipment during your stay.

• Chest X-ray: This is a picture of the lungs and heart.
• Taking Vital Signs: These include your temperature, pulse, blood pressure and respiration. A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm. These tests may be performed hourly.
• IV: This is a tube placed in your vein for giving medications or liquids. It will either be capped or have tubing connected to it.
• Electrocardiogram: Also known as an ECG, EKG, or heart monitor, this diagnostic tool employs electrodes, or patches, placed on your chest. The patches are hooked up to a TV-type screen or small portable box that shows a tracing of each heartbeat.
• Echocardiogram: This device uses sound waves to construct an image of the heart. To take the picture, a conductive jelly is applied to your chest and a paddle is placed on top of it.
• MRI: This machine produces images of your internal organs that can help the doctors assess the extent of the damage to your heart. To get the pictures, you will need to lie on a narrow bed that slides into a scanner.
• Cardiac Catheterization: This test helps the doctor study the arteries that send blood to your heart and measure pressure within the heart.
• Surgery: May be needed to remove some heart muscle to improve outflow of blood from the heart. If the situation is especially serious and you have no other major diseases, you may be scheduled for a heart transplant.

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