Cardiomyopathy Treatment in Delhi, India

Cardiomyopathy is a complex heart condition characterised by the weakening of the heart muscle, leading to impaired blood flow. It can affect people of all ages and, if left untreated, may lead to severe complications, such as heart failure or arrhythmias.

Associated Anatomy of Cardiomyopathy

Heart, myocardium

Alternate Name of Cardiomyopathy

Hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy.

Types of Cardiomyopathy

Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is usually genetic and occurs when the heart muscles become thick and prevent the blood flow through your heart.

Dilated cardiomyopathy

It is the most common type of cardiomyopathy and occurs as a result of an enlarged heart muscle. This makes the heart too weak to pump blood efficiently. It can be inherited or be the result of coronary artery disease, valve disease, congenital heart disease etc.

Restrictive cardiomyopathy

It occurs due to stiffening of the ventricles, resulting in inadequate filling of the blood.

Ischemic cardiomyopathy

Ischemic cardiomyopathy occurs when coronary arteries become narrowed or obstructed, decreasing blood flow to the heart muscle. This condition often results from a previous heart attack, which weakens the heart's ability to pump blood effectively. Patients may experience symptoms such as chest pain, fatigue, and shortness of breath.

Arrhythmogenic right ventricular dysplasia (ARVD)

ARVD is a rare inherited condition characterised by the replacement of healthy heart muscle in the right ventricle with fatty or fibrous tissue. This can lead to life-threatening arrhythmias. Symptoms include palpitations, dizziness, and fainting, primarily affecting young adults and athletes.

Transthyretin amyloidosis cardiomyopathy (ATTR-CM)

ATTR-CM occurs when abnormal deposits of the protein transthyretin accumulate in the heart, leading to thickening and stiffening of the heart muscle. This condition is more common in older adults and can be hereditary or acquired. Symptoms may include fatigue, shortness of breath, and leg swelling.

Broken heart syndrome (Takotsubo cardiomyopathy)

Often triggered by severe emotional or physical stress, broken heart syndrome mimics the symptoms of a heart attack. The heart's left ventricle temporarily weakens and balloons out, leading to chest pain and shortness of breath. Fortunately, this condition is usually temporary and reversible with proper treatment.

Chemotherapy-induced cardiomyopathy

Certain chemotherapy drugs can damage heart cells, leading to chemotherapy-induced cardiomyopathy. This type of cardiomyopathy may develop during or after cancer treatment and requires careful monitoring and management. Symptoms may consist of fatigue, shortness of breath, and swelling.

Alcohol-induced cardiomyopathy

Excessive alcohol consumption over an extended period can weaken the heart muscle, leading to alcohol-induced cardiomyopathy. This condition is preventable and may be reversible with lifestyle changes, including reducing or eliminating alcohol intake.

Left ventricular non-compaction (LVNC)

Left ventricular non-compaction (LVNC) is a rare congenital condition in which the heart muscle in the left ventricle doesn't develop properly, leading to a spongy appearance. This can result in heart failure, arrhythmias, and blood clots. Symptoms vary widely but may include fatigue, shortness of breath, and palpitations.

Peripartum cardiomyopathy

Peripartum cardiomyopathy is a rare but serious condition that occurs in the last month of pregnancy or within five months after delivery. The heart becomes weakened, leading to symptoms of heart failure such as swelling, fatigue, and shortness of breath. Early diagnosis and treatment are crucial for a favourable outcome.

Cardiomyopathy Causes

Mostly, cardiomyopathy occurs without any warning, and the cause remains unknown. In other cases, the cause can either be inherited or acquired. Having inherited causes means you were born with cardiomyopathy due to your parents' genes, whereas having acquired causes means you got them as a consequence of another disease or factor.

Some common causes of cardiomyopathy are listed below:

• Coronary artery disease

• Valvular heart disease

• Infection in the heart muscle

• A family history of heart attacks, sudden cardiac arrest, or cardiomyopathy

• Hypertension

• Autoimmune disease

• Diabetes

• Alcohol abuse

• Viral infections

• Conditions that damage the heart, like high cholesterol

• Drugs like cocaine, amphetamines, and anticancer medications

Cardiomyopathy Symptoms

The signs and symptoms associated with cardiomyopathy are listed below:

• Fatigue

• Shortness of breath

• Rapid heartbeats or heart palpitations

• Chest pain

• Swelling of the lower limbs

• Dizziness

• Restlessness, agitation due to low oxygen in the brain

• Unconsciousness or syncope

• Ascites, or bloating of the stomach

• Swelling in the lower limbs
• Coughing when lying in a horizontal position

Cardiomyopathy Diagnosis

Chest X-ray

A diagnostic chest X-ray is performed to determine whether the heart is enlarged.

Cardiac CT

Cardiac CT is a procedure that uses X-rays to create a video of the heart and blood arteries.

Cardiac Catheterization

A catheter (a tiny tube put into a blood vessel) is used to measure the heart's blood flow and pressure during cardiac catheterization.

Echocardiography

During an echocardiogram, sound waves are used to create an image of your blood flow and heartbeat.

Angiography

Angiography is used to rule out ischemic heart disease. A dye is injected into the vein to highlight any blockage in the artery.

Cardiac MRI

Cardiac MRI creates images of the heart using radio waves and magnets.

Electrocardiogram (ECG)

An ECG is a non-invasive test that records the heart's electrical activity. It can detect abnormalities in heart rhythm, structure, and function, providing valuable information for diagnosing cardiomyopathy.

Stress Test

The purpose of an exercise stress test is to boost your heart rate in a controlled manner to see how your heart reacts to stress.

Myocardial biopsy

A small sample of heart muscle tissue is examined for cell alterations during a myocardial biopsy.

Ambulatory monitoring

Ambulatory monitoring involves wearing a portable device, such as a Holter monitor, that records the electrical activity of the heart for around 24 to 48 hours or longer. This test helps detect irregular heart rhythms (arrhythmias) and assess the severity of the condition.

Blood tests

Blood tests can identify markers of heart damage, such as elevated levels of certain enzymes and proteins, as well as underlying conditions like thyroid disorders or infections that may contribute to cardiomyopathy.

Cardiomyopathy Treatment

The treatment of cardiomyopathy varies depending on its type, cause, and severity of symptoms.

Medication

It includes diuretics, ACE inhibitors, beta-blockers, calcium channel blockers, and digoxin.

Devices to Correct Cardiomyopathy

• Pacemakers: These devices help regulate abnormal heart rhythms by sending electrical impulses to the heart.
• Implantable Cardioverter Defibrillators (ICDs): ICDs monitor heart rhythms and deliver shocks if life-threatening arrhythmias are detected, preventing sudden cardiac death.

Devices to Improve Blood Flow

• Cardiac Resynchronisation Therapy (CRT): CRT uses a special pacemaker to improve the timing of the heart's contractions, enhancing its efficiency.
• Left Ventricular Assist Device (LVAD): LVADs are mechanical pumps that help the heart pump blood from the left ventricle to the rest of the body. They are often used in cases of severe heart failure.

Surgery

If symptoms are severe and medications aren't working, valve surgery, bypass surgery, or a heart transplant may be an option.

• Septal myectomy: It includes removing some cardiac tissue to increase blood flow through the heart. Via open heart surgery.
• Heart transplant: In cases of advanced heart failure where alternative therapies have proven ineffective, a heart transplant may represent the sole viable solution.
• Alcohol septal ablation: This procedure treats hypertrophic cardiomyopathy by injecting alcohol into the small artery supplying the thickened heart muscle, reducing its size.
• Catheter Ablation: This procedure targets and destroys the small areas of heart tissue causing arrhythmias, helping to restore normal rhythm.

Risk Factors of Cardiomyopathy

Cardiomyopathy can affect anyone at any age. The following conditions or lifestyle choices can act as risk factors for cardiomyopathy:

• A family history of cardiomyopathy, cardiac arrest, or heart failure is a major risk factor.
• Long-term high blood pressure
• Coronary artery disease (CAD) or cardiovascular illness

• Previous heart attacks

• Infections that induce heart inflammation and heart valve problems

• Diabetes

• Obesity

• Thyroid problems

• Abnormalities of the connective tissue

• Cocaine or amphetamine abuse

• Certain cancer treatment options

• Toxins, such as lead and mercury

• Cocaine and alcohol abuse

• Sarcoidosis

• Hemochromatosis
• Amyloidosis

Complication of Cardiomyopathy

Cardiomyopathy can be life-threatening. Since the heart can't pump blood effectively, blood clots might form in the heart. If clots enter the bloodstream, they can block blood flow to other organs, including the heart, lungs, and brain. The heart valves might not close properly, causing blood to flow backwards in the valve. Cardiomyopathy can trigger an irregular heartbeat that causes fainting. In some cases, it can also lead to heart failure or sudden cardiac arrest.

Cardiomyopathy Preventions

Primary Prevention of Cardiomyopathy

Cardiomyopathy is genetically inherited and cannot be prevented. However, its symptoms can be reduced by following a healthier lifestyle. Early detection and treatment of etiological factors can help lead a better quality life.

Secondary Prevention of Cardiomyopathy

• Diet: Limit your intake of sugary, fried, fatty, and processed meals to maintain a heart-healthy diet. Eat more fruits, vegetables, whole grains, lean proteins, nuts, seeds, and low-fat dairy. Limit your salt (sodium) intake.

• Maintain a healthy weight.

• Stop smoking: Smoking can harm your heart, blood, blood vessels, and overall cardiovascular system.

• Exercise regularly: Limit your sitting time and aim to exercise for at least 30 minutes on most days of the week.

Epidemiology of Cardiomyopathy

• Cardiomyopathy can affect as many as one in every 500 adults.
• Cardiomyopathy can affect men and women of different ages and races.
• Blacks have a higher rate of dilated cardiomyopathy than whites, and males have a higher rate than females.
• The most prevalent inherited or genetic cardiac condition is hypertrophic cardiomyopathy.

Expected Prognosis of Cardiomyopathy

Cardiomyopathy can be fatal and reduce life expectancy. As the disease progresses, it worsens over time if left untreated. Treatments can help you live longer by reducing the deterioration of your heart's condition. If you have cardiomyopathy, you must adjust your lifestyle to improve your heart's health. Visit your doctor for regular treatment and follow-ups.

Natural Progression of Cardiomyopathy

The progression of the disease varies greatly from person to person. In some people, symptoms may appear suddenly and worsen quickly. Others may see a gradual development over a period of time. Patients experience abnormal heart rhythms and cardiac failure as the disease progresses. Sudden death due to ventricular arrhythmias can also occur.

Pathophysiology of Cardiomyopathy

Due to the underlying cause, there is inflammation and rapid degeneration of myocardial fibres, resulting in ventricular dilation. Blood flow is stagnant or slow in the chambers of the dilated heart. It results in weaker contractions of the ventricles to pump blood. Less cardiac output reduces oxygen supply to the body and leads to the failure of the heart.

Outlook

The outlook for cardiomyopathy varies depending on the type, severity, and timeliness of treatment. With early diagnosis and appropriate management, many patients can lead active lives and manage symptoms effectively. However, some forms of cardiomyopathy, particularly those that are genetic or progressive, may require long-term care and monitoring.

Frequently Asked Questions

1. What can I expect if I have cardiomyopathy?

Patients with cardiomyopathy should expect regular monitoring and treatment to manage symptoms and prevent complications. Lifestyle changes and medication adherence are crucial for maintaining heart health.

2. How long does cardiomyopathy last?

The duration of cardiomyopathy varies depending on the type and response to treatment. Some forms may be temporary, while others can be chronic and require lifelong management.

3. How do I take care of myself?

Patients should follow their healthcare provider's advice, including taking prescribed medications, maintaining a healthy diet, exercising regularly, avoiding alcohol, and attending regular check-ups.

4. How common is cardiomyopathy?

Cardiomyopathy affects millions of people worldwide, with varying prevalence depending on the type. It can occur in people of all ages, though some forms are more common in specific populations.

5. Is cardiomyopathy curable?

While some forms of cardiomyopathy are manageable with treatment, others may not be curable. However, many patients can achieve a good quality of life with proper care.

Related Blogs

• What Are the 4 Stages and Treatment of Congestive Heart Failure?
• Broken Heart Syndrome: Its Very Much Real
• Chest Pain: Its Major Reasons & Preventive Lifestyle Changes
• Surgical Options For Heart Failure: When Is It Necessary?