Cardiomyopathies: definition, causes, symptoms, diagnosis and treatment

By Cristiano Antonino On Apr 18, 2023

Cardiomyopathies are pathologies that affect the heart muscle and reduce the capacity of the heart which is no longer able to satisfy its blood pumping properties to the whole body

Cardiomyopathies can be: dilated, hypertrophic and restrictive

Among the most common are dilated cardiomyopathies, which cause problems in the left ventricle that dilates and is unable to pump blood regularly.

Hypertrophic cardiomyopathies see growth and/or thickening of the heart muscle which will see its functionality compromised.

In restrictive cardiomyopathies the heart will lose its capacity and tend to stiffen.

Cardiomyopathy can lead to heart failure, blood clots, heart valve problems, and sudden death.

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Causes

Most dilated cardiomyopathies are associated with ischemic causes, such as myocardial infarction and coronary heart disease; in younger patients, idiopathic forms will be found more frequently, the cause of which will therefore not be known.

There may be links with heredity and familiarity, hypertension, heart valve disease, tachycardia, alcohol and drug abuse, chemotherapy drugs, it is rarer that there may be links with infectious diseases.

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In hypertrophic cardiomyopathies the causes will be mainly genetic

In the restrictive forms, which are the least frequent, the causes could be associated with infiltrations of the heart muscle, for other forms the cause is not known.

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Symptoms of cardiomyipathies

Typically, in the early stages, heart disease will not show any symptoms; however, as the disease progresses, heart failure-related disorders such as breathing difficulties, swelling of the lower limbs, irregular heartbeats, tachycardia, fainting, dizziness may appear.

Regardless of the type of cardiomyopathy, symptoms will tend to get worse.

In order to prevent cardiomyopathies it will be necessary to follow a correct lifestyle, following a correct diet, carrying out regular physical activity, avoiding smoking for tobacco users, avoiding the consumption of alcohol.

For hypertensive patients, suffering from diabetes mellitus, or with high cholesterol levels, it is recommended to keep these risk ‘factors’ under control.

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Diagnosis

The diagnosis of cardiomyopathy is based on accurate medical examinations, in which the presence of cardiological problems in the family history will be investigated.

You may need to do: chest X-ray, electrocardiogram, echocardiogram, exercise testing, myocardial scan, cardiac MRI, blood tests.

From the outcome of the results of these tests it will be seen whether it will be appropriate to perform other tests such as coronary angiography, hemodynamic study, myocardial biopsy.

Regardless of the cardiomyopathy and the present disorder, the most suitable treatment will be followed; The goal of treatment is to reduce symptoms, prevent them from getting worse, and reduce the occurrence of complications.

If you have dilated cardiomyopathy, you will need to take drugs such as ACE inhibitors and beta-blockers, surgery to implant pacemakers and defibrillators, or treatment that includes surgery and drug therapy.

If you have hypertrophic cardiomyopathy, you may need to take beta-blockers, calcium channel blockers, or even antiarrhythmics.

If the pharmacological treatment is not enough, it will be necessary to intervene surgically to implant a pacemaker or defibrillator.

If you have restrictive cardiomyopathy, the focus will be on improving your symptoms.

It may be necessary to reduce the amount of salt and monitor body weight.

You will be prescribed diuretics, medicines that reduce blood pressure or monitor your heart rate.

Knowing the causes of cardiomyopathy will make it easier to prescribe specific treatments.

The disease may progress, even if treatments are followed; therefore, transplantation or implantation of a ventricular assist device will be required.

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