Cardiomyopathy

Cardiomyopathy Overview

Cardiomyopathy describes diseases of the heart muscle. Within the spectrum of this broad disease, the heart muscle may become baggy and dilated, or alternatively, thickened and stiff. Both situations lead to inadequate circulatory volume delivered to the end organs. Cardiomyopathy may lead to congestive heart failure, blood clots, heart murmurs or arrhythmia.

Cardiomyopathy can be treated, although your Wellstar Cardiac Physician will prescribe a treatment based on the type and severity of your condition. It can be acquired through complications from another disease or condition. You can inherit the condition from your parents. The main types of cardiomyopathy are:

Dilated cardiomyopathy, a condition in which the heart becomes weakened and enlarged (dilated). An idiopathic (unknown) dilated cardiomyopathy may occur after an upper respiratory tract infection, caused by a virus, in a patient with a sustained and untreated very rapid heart rate (tachycardia-induced cardiomyopathy), or after a large heart attack (ischemic cardiomyopathy). In this disorder, the most common form of cardiomyopathy, the pumping of the heart is less predictable, and more blood backs up into the lungs, legs, and abdomen.
Hypertrophic cardiomyopathy, a disorder that involves abnormal growth or thickening of your heart muscle, most often in the left ventricle, the main pumping organ of the heart. As thickening occurs, the heart tends to stiffen and the size of the pumping chamber shrinks, thus interfering with the heart’s ability to deliver blood through the body.
Restrictive cardiomyopathy, a condition where the heart muscle becomes rigid and less elastic. The heart cannot properly expand and fill with blood between heartbeats.

Symptoms

Many patients do not exhibit symptoms in the early stages of cardiomyopathy. When the condition advances, signs and symptoms usually appear. These may include:

Shortness of breath (dyspnea) with minimal activity or when a patient lies down
Fatigue, faintness and weakness
Swelling (edema) of feet and ankles
Swelling of the abdomen (ascites)
Rapid or irregular heartbeat or pulse

Risk Factors

People of all ages can have cardiomyopathy, although certain types of the disease appear more often in certain groups than others. For example, dilated cardiomyopathy is more common in men than in woman and in Blacks than in Caucasians. Certain diseases, conditions or factors can raise your risk for cardiomyopathy. Such factors include:

A family history of cardiomyopathy, congestive heart failure or cardiac arrest
High blood pressure
Coronary artery disease
Diabetes, other metabolic diseases or severe obesity
Diseases that damage the heart
Long-term, excessive alcohol use

Cardiomyopathy Prevention

In most cases, you cannot prevent cardiomyopathy. You can take steps to lower your risks that may lead to or exacerbate the symptoms. Inform your Wellstar Cardiac Network Physician if you have a family history of cardiomyopathy, congestive heart failure or cardiac arrest.

Reduce Your Risk of Cardiomyopathy

You can lower your chances of cardiomyopathy through several methods:

Maintain a healthy weight
Don’t smoke or drink excessive alcohol
Eat healthy foods and reduce sodium intake
Exercise as recommended by your Wellstar physician
Monitor cardiac risk factors, such as high blood pressure and diabetes

Tests and Screenings

Your Wellstar physician will conduct a physical examination and look over your personal and family medical history. Through a physical, your physician can determine if you have a heart murmur or swelling in your legs or abdomen or other signs of cardiomyopathy or related conditions.

Based on the exam, your physician might order:

Chest X-ray to determine whether your heart has become enlarged
Blood tests to check kidney and thyroid functions, and B-type natriuretic peptide, a protein produced in the upper heart chambers that may be increased in the presence of congestive heart failure
Electrocardiogram (ECG) to record the electrical activity of your heart, looking for arrhythmia or prior heart attacks
Echocardiogram, an ultrasound test, designed to show the pumping performance of your heart as well as the heart’s valvular structure and function
Cardiac stress tests, which measure your hearts performance during exertion
Cardiac computerized tomography (CT) scan or magnetic resonance imaging (MRI)
Cardiac catheterization (and infrequently biopsy), in which a thin, flexible tube (catheter) is inserted into your groin or arm and guided through the aorta and the vena cava, to obtain pressure measurements and evaluate the arteries. Your cardiologist will be looking for valve defects, elevated pressures or blockages.

Cardiomyopathy Diagnosis

If screening tests or check-ups reveal abnormal results, your Wellstar physician will perform further evaluations regarding cardiomyopathy.

Procedures

Chest X-rays
Blood tests
Electrocardiogram (ECG)
Echocardiogram
Cardiac Stress Tests
Cardiac Computerized Tomography (CT) Scan or Magnetic Resonance Imaging (MRI)
Coronary Catheterization and Biopsy

Cardiomyopathy Treatment

The goals of treatment for cardiomyopathy are to manage your signs and symptoms, prevent the conditioning from worsening and reduce your risks of further complication. Treatment methods—medications, surgery, pacemakers and, in the most severe of cases, heart transplants—vary greatly depending upon the type of cardiomyopathy you have.

Taking Care of Dilated Cardiomyopathy

If you are diagnosed with dilated cardiomyopathy, your Wellstar Cardiac Physician may prescribe medications or suggest surgically implanted devices as part of your treatment. Medications you may be prescribed include:

Angiotensin-converting enzyme (ACE) inhibitors. These medications help ease pressure on blood vessels by blocking the formation of natural chemicals that narrow the vessels, thus decreasing the workload on the heart. Examples include enalapril (Vasotec^®), lisinopril (Prinivil^®, Zestril^®) and captopril (Capoten^®).
Angiotensin II receptor blockers. These medications help relax blood vessels by blocking the action—not the formation—of natural chemicals that narrow vessels. These include losartan (Cozaar^®) and valsartan (Diovan^®).
Blood thinners or Anticoagulant (Anti-clotting) drugs. These medications prevent blood clots from forming in your heart or in your blood vessels.
Digoxin (Lanoxin^®). This medication, also known as digitalis, may decrease the frequency of congestive heart failure and tends to slow the heartbeat.
Diuretics. Sometimes called “water pills,” these medications work on your kidneys to help your body eliminate sodium and water, thus reducing blood volume. Diuretics most often prescribed for heart failure include bumetanide (Bumex^®) and furosemide (Lasix^®). Because diuretics also cause you to eliminate essential minerals such as potassium and magnesium, your Wellstar physician may also prescribe supplements or a diuretic that maintains certain mineral levels.
Beta blockers. Usually combined with a diuretic, these medications reduce the heart’s workload and expand blood vessels, thus causing your heart to work slower and with less force. These may include carvedilol (Coreg^®), metoprolol (Lopressor^®) and bisoprolol (Zybeta^®).

Because cardiomyopathy patients are at greater risk for lethal arrhythmias, surgically implanted devices may be necessary and would be implanted by an electrophysiologist.

An implantable cardioverter-defibrillators (ICD), a heart-monitoring device that shocks your heart back into normal rhythms, or cardiac resynchronization therapy (CRT), a type of pacemaker, which may prevent recurring episodes of congestive heart failure, may be necessary.

Taking Care of Hypertrophic Cardiomyopathy

Similarly with dilated cardiomyopathy, your Wellstar Cardiac Physician may prescribe a combination of medications (beta blockers are most common) or surgically implanted devices if you have been diagnosed with hypertrophic cardiomyopathy.

Taking Care of Restrictive Cardiomyopathy with Surgery

As with the other two forms of cardiomyopathy, your Wellstar physician may prescribe a combination of medications or surgically implanted devices if you have been diagnosed with restrictive cardiomyopathy.

Ongoing Care for Cardiomyopathy

Wellstar offers world-class, community-based physicians based in state-of-the-art medical centers and hospitals with access to the latest technologies and other medical resources. They are dedicated to:

Help you create and maintain healthy lifestyles
Offer advice to prevent illness and injuries
Provide early and appropriate care of acute illness to prevent its progression

Heart Care at Wellstar

Wellstar’s Cardiovascular Network provides top-flight Cardiac Care throughout its physicians’ offices, urgent care centers and emergency rooms. Emergency departments at Wellstar Cobb, Wellstar Douglas, Wellstar Kennestone, and Wellstar Paulding hospitals provide comprehensive cardiac services. Wellstar Cobb and WellStar Kennestone hospital’s cardiac diagnostic and treatment services provide the next level of defense against heart disease. The technologically advanced Cardiac Center at Wellstar Kennestone Hospital and partnership with Emory Healthcare for adult open-heart surgery raises the bar on world-class cardiac care. Wellstar’s Cardiac Rehabilitation Services’ medically supervised programs focus on helping heart disease patients maintain a healthier heart through education and support groups.

Ongoing Care at Home

Although cardiomyopathy is chronic (long-term), treatment can often improve symptoms and help you live longer. You and your Wellstar physician can work together to make your life more comfortable, so pay close attention to your body and your post-treatment regimen, and keep your doctor updated. As part of your post-treatment care and in addition to maintaining a healthy diet and exercise, you should:

Keep track of all medications you take
Keep track of your weight and blood pressure
Write down your questions and never be afraid to ask your Wellstar physician for clarification regarding your condition or your treatment