Cardiomyopathy consists of a number of cardiovascular illnesses that affect the heart and can cause it to malfunction. The walls of the heart consist of three parts. The inner surface is formed by a thin layer of tissues called the endocardium. Then there is the heart muscle itself, myocardium, and on its surface is another thin layer of tissue called the epicardium. The heart, especially the myocardium, is not exempt from diseases. Some of these diseases are caused by cardiomyopathy, a group of certain disease that are, to a certain extent, similar. It is interesting that cardiomyopathy can be present for a long time without manifesting any symptoms. In some patients cardiomyopathy is a long term disease, and in others it appears suddenly and is the cause of sudden death of an otherwise healthy, young individual.
The Causes of Cardiomyopathy
The causes of cardiomyopathy vary. Cardiomyopathy can develop as a result of various infections affecting the cardiac muscle, defects of the valves, or following ischemic heart disease. Individuals who consume alcohol often are more likely to be affected by cardiomyopathy. It can also accompany certain systemic diseases such as rheumatoid arthritis or scleroderma. Cardiomyopathy can occur in patients affected by metabolic disorders such as high or low thyroid activity, or it can develop as a reaction to long-term high blood pressure due to the use of certain medications. Inheritance can play a role in increasing ones risk of cardiomyopathy, though its cause usually remains unknown. Consequences include changes in the myocardium, which can be excessively thick, or conversely, too stretched. Sometimes changes in the myocardium are not obvious at first glance, these are changes occurring at a microscopic level, where muscle fibers diminish (myocardium is made up of muscle fibers under normal circumstances) and connective tissue accumulates.
Symptoms and Consequences of Cardiomyopathy
Symptoms of cardiomyopathy depend on its type, whether the myocardium is stretched or thickened. This is called dilated or hypertrophic cardiomyopathy. In short it can be said that the heart usually slowly stops performing its function, leading to heart failure. This is manifested by shortness of breath, fatigue, decreased performance, swelling of the lower limbs, loss of consciousness, or chest pain. Hypertrophic cardiomyopathy, where the walls are thickened, can be asymptomatic. Because a part of the myocardium includes the electrical system of the heart, cardiomyopathy can cause dysfunction of the heart's beating, resulting in arrhythmia. The affected heart can have an increased tendency to develop blood clots which can be expelled and wedged in the blain, causing a stroke. The consequences of heart failure can result in immediate death.
A diagnosis of cardiomyopathy is based on a detailed medical history, an analysis of clinical manifestations and a physical examination done by a doctor. When listening to the heart's rhythm with a stethoscope, the physician may notice arrhythmia, i.e. an irregular heartbeat. In order to ensure a correct diagnosis, imaging devices must be used. These include an x-ray of the lungs and an echocardiograph, an ultrasound of the heart in with which changes of the heart's walls can be observed. Because symptoms are similar to ischemic heart diseases, it is important to eliminate other possible diseases by performing a coronary angiography; allowing the blood vessel to be viewed under x-rays following the injection of a contrasting agent.
Despite advances in the diagnosis and treatment of cardiomyopathy, the prognosis of this disease is still often unfavourable, especially in the elderly already suffering from other diseases. Treatment of cardiomyopathy is not always easy.
Treating Dilated Cardiomyopathy
The treatment of dilated cardiomyopathy is based on pharmacotherapy. Medications from various groups are administered, primarily medications to lower blood pressure and heart rate. In the event of blood stasis, diuretics are prescribed. So that the development of vein thrombosis (blood clots) can be prevented, it is important to administer an anticoagulant; Warfarin is typically prescribed, though aspirin can be taken as well. Of course, physical calm and a limited salt intake are every important as well. In the most severe cases, a heart transplant may be necessary.
Treating Hypertrophic Cardiomyopathy
The treatment of hypertrophic cardiomyopathy includes physical calm, and effective pharmacotherapy. Patients take diuretics to lower high blood pressure by excreting fluid from the body. It is also important to administer antiarrhythmics and medication to lower heart rate. Patients with the hypertrophic form of cardiomyopathy and who are at risk of sudden death, have a cardioverter – defibrillator preventatively implanted. This is a special device that stimulates the heart to contract. In the most severe cases, the patient may be suitable for an artificial heart and a heart transplant.