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Cardiomyopathy
Definition
Cardiomyopathy is a weakening of the heart muscle or another problem with the heart muscle. It often occurs when the heart cannot pump as well as it should, or with other heart function problems.
Most patients with cardiomyopathy have heart failure.
Causes
Different types of cardiomyopathy exist, and they have many different causes:
- Dilated cardiomyopathy is a condition in which the heart becomes weak and the chambers get large. As a result, the heart cannot pump enough blood out to the body. Many different medical problems cause this type of cardiomyopathy.
- Hypertrophic cardiomyopathy (HCM) is a condition in which the heart muscle becomes thick. The thickening makes it harder for blood to leave the heart. This type of cardiomyopathy is usually passed down through families.
- Ischemic cardiomyopathy is caused by narrowings in the arteries that supply the heart with blood. It it makes the heart walls thin so they do not pump well.
- Restrictive cardiomyopathy is a group of disorders. The heart chambers are unable to properly fill with blood because the heart muscle is stiff. The most common causes of this type of cardiomyopathy are amyloidosis and scarring of the heart from an unknown cause.
- Peripartum cardiomyopathy occurs during pregnancy or in the first 5 months afterward.
Treatment
When possible, the cause of cardiomyopathy is treated. Medicines and lifestyle changes are often needed to treat the symptoms of heart failure, angina, and abnormal heart rhythms.
Different procedures or surgeries may also be used:
- A defibrillator sends an electrical pulse to stop life-threatening abnormal heart rhythms.
- A pacemaker treats a slow heart rate or helps both sides of your heart beat at the same time.
- Coronary artery bypass (CABG) surgery or angioplasty can improve blood flow to the damaged or weakened heart muscle.
- Heart transplant is used when all other treatments have failed.
Recently, implantable artificial heart pumps have been developed. However, very few patients are able to have this advanced treatment.
Outlook (Prognosis)
The outlook depends on many different things, including:
- Cause and type of cardiomyopathy
- How well you respond to treatment
- The severity of the heart problem
Heart failure is usually a long-term (chronic) illness. It may get worse over time. Some people develop severe heart failure that medicines, surgery, and other treatments can no longer help.
Patients with certain types of cardiomyopathy are at risk for dangerous heart rhythm problems.
References
Hare JM. The dilated, restrictive, and infiltrative cardiomyopathies. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 68.
Wexler RK, Elton T, Pleister A, Feldman D. Cardiomyopathy: An overview. Am Fam Physician. 2009;79:778-784.
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc. Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington.
