The condition of cardiomyopathy combines a number of heart-muscle conditions that lead to a decreasing functioning of the heart, therefore developing a cardiomyopathy.
All cardiomyopathies have in common, that a malfunction of the heart develops. These are usually pump dysfunctions that, depending on the type of cardiomyopathy, either cause lesser amounts of blood being pumped into the body circulation due to the heart muscle’s insufficient strength, or lesser amounts of blood being pumped into the lung circulation due to e.g. the respective heart cavity became too small.
There are 5 main types of cardiomyopathy. A dilative cardiomyopathy (“sacculation“ and enlargement of the heart, so that lesser amounts of blood are being pumped into the body circulation) occurs due to genetic factors, as part of circulatory disorders of the heart (coronary heart disease) and heart attack, following virus infections. Patients suffer from breathlessness, cardiac arrhythmia and general symptoms such as weakness and fatigue. Hypertrophic cardiomyopathy leads to a thickening musculature mainly of the left heart, without gaining any strength. On the contrary, muscle strength rather decreases! The result is a decrease in the amount of blood being pumped into the body circulation, due to the reduced muscle strength (non-obstructive type) or due to movements/tightening of the blood’s path (obstructive type). Hypertrophic cardiomyopathy also shows symptoms such as breathlessness under strain, cardiac arrhythmia and the general symptoms mentioned above. Restrictive cardiomyopathy occurs when the heart muscle becomes very stiff. It can’t be filled with the sufficient amount of blood anymore, and the blood accumulates in front of the heart. This also leads to breathlessness, but also to an enlarged liver and spleen and may cause dysfunctions. Patients also suffer from swollen and heavy legs. The fourth type is arrhythmogenic right ventricular cardiomyopathy. When suffering from this type, heart muscle tissue is being more and more replaced by fatty and connective tissue. This tissue is less durable and tends to sag out, similar to the dilative cardiomyopathy. Fatty and connective tissue also doesn’t have the functions of muscle tissue and can’t contract to pump blood into the circulation. Patients suffer from short periods of unconsciousness, irregular heartbeat and heart palpitations. The fifth type is non-classifiable cardiomyopathies. All types can lead to sudden cardiac death.
Some examinations are required to identify the type of cardiomyopathy. The symptoms provide a first idea. One of the first measures is usually an ECG and the analysis thereof, followed by chest x-rays as well as a heart ultrasound. The blood parameters will be determined, and a catheter examination of the heart or a sample taking may be considered as well. Therapy and prognosis depend on the identified type of cardiomyopathy. All measures include omission of substances or habits that can damage the heart (alcohol, smoking, certain medication), as well as rest. Cardiac insufficiency will be treated as well, but with different approaches. Additional specific measures are necessary for the respective types. This may include therapy of the underlying cause, pacemaker implantation, surgeries or even a heart transplant. The doctor will discuss the individual therapy with the patient. All cardiomyopathies are serious conditions that can strongly impair the patients’ daily activities and require intensive therapy, depending on the stage of severity. Despite all options, sudden cardiac death or other life-threatening complications occur frequently.
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