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Cardiomyopathy

What is cardiomyopathy?

Cardiomyopathy is a group of conditions that affects the muscle of the heart and reduces its ability to pump blood around the body. It can alter the shape of the heart or the size and thickness of the muscle walls.

Cardiomyopathy is often an inherited disease caused by a mutation in a person’s DNA that affects how the heart develops, but it can also be caused by viral infections, diseases that attack the immune system and some medical treatments such as those used to treat cancer.

There are six types of cardiomyopathy, as follows:

Dilated cardiomyopathy (DCM)
This occurs when the muscle wall of the left ventricle becomes enlarged and stretched, thus weakening the heart. DCM can affect anyone but if it develops during pregnancy it may be referred to as peripartum cardiomyopathy.

Hypertrophic cardiomyopathy (HCM)
This occurs when the muscle of the ventricle thickens, known as ‘hypertrophy’, which makes the ventricle smaller. As a result the heart has to work harder and HCM can also block the flow of blood out of the heart.

Arrhythmogenic right ventricular cardiomyopathy (ARVC)
Also known as arrhythmic cardiomyopathy, ARVC occurs when heart muscle cells are not joined together properly. As a result the cells die and get replaced by scar tissue or fat, which makes the heart muscle stretched, thinner and weaker.

Restrictive cardiomyopathy (RCM)
This occurs when the heart muscle becomes stiff and cannot relax properly, which makes it harder for the top chambers to fill with blood. The chambers then become enlarged and blood cannot flow properly.

Left ventricular noncompaction (LVNC)
LVNC is as a result of how the heart muscle develops in an unborn baby. The muscle cells do not pack together and this causes small indentations in the muscle, which appears spongy, and affects the performance of the heart.

Takotsubo or ‘broken heart’ syndrome
This usually happens during a time of extreme stress, hence the name ‘broken heart’, when the left ventricle becomes enlarged and weakened. It is often only temporary, and usually gets better with time.

Symptoms

What are the symptoms of cardiomyopathy?

Many people have cardiomyopathy without displaying any symptoms, whereas others may experience breathlessness, dizziness, fainting, tiredness, chest pain, palpitations, and in some cases swelling in the abdomen and ankles.

Symptoms

Assessment

What assessment do I need if I have cardiomyopathy?

Your cardiologist will explore your family’s health history and you would normally have an ECG (electrocardiogram) and either an echocardiogram or MRI/CMR scan. As cardiomyopathy can be inherited, it may be that we would recommend that your first degree relatives are advised to have screening tests as well (ECG and echocardiography).

Treatments

What are the treatments for cardiomyopathy?

Unfortunately there is no cure for cardiomyopathy; however many people take medication to alleviate the symptoms. Medication regularly prescribed includes anti-coagulants to thin the blood and reduce the risk of blood clots, diuretics to reduce the build-up of fluid, and beta-blockers to reduce the heart rate.

Some people will have a medical device inserted into their body during a surgical procedure, either a pacemaker that controls the rhythm of the heart or an ICD (implantable cardioverter defibrillator) which controls the rhythm and shocks the heart if the rhythm changes from normal to a dangerous rhythm.

In a small number of cases, people undergo surgery to remove some heart muscle if it affects blood flow, and in very few situations people have to have a heart transplant.

  • Atrial Fibrillation (AF) Catheter Ablation

    This is an invasive procedure to block the electrical signals causing atrial fibrillation and to restore sinus rhythm. [READ MORE]

  • Atrial Flutter Ablation

    This procedure blocks the electrical signals that cause a fluttering heartbeat and restores sinus rhythm. [READ MORE]

  • CTCA Scan & Calcium Score

    This scan is used to ascertain the risk of a heart attack or stroke within the next 5-10 years. [READ MORE]

  • Echocardiogram (TTE)

    An ‘echo’ is an ultrasound scan of the heart to assess structure and function. [READ MORE]

  • Electrocardiogram (ECG) Test

    An ECG is a simple test that looks at the electrical activity of the heart. [READ MORE]

  • Implantable Cardioverter Defibrillator (ICD)

    This is an artificial device implanted in the chest to detect and correct a potentially dangerous heartbeat. [READ MORE]

  • MRI Scan / CMR Scan

    These scans enable cardiologists to view detailed images of the heart’s anatomy. [READ MORE]

  • Pacemaker & Implanting a Pacemaker

    This is an artificial device that is implanted in the chest to regulate an abnormal heartbeat. [READ MORE]

  • Stress Echocardiography

    This is a procedure that uses ‘echo’ and ECG to assess how the heart’s blood vessels are working using either exercise or a drug to increase the heart rate. [READ MORE]

  • Transoesophageal Echocardiogram (TOE)

    Sometimes an ‘echo’ scan of the heart requires an ultrasound probe to be passed down the food pipe to provide a clearer image. [READ MORE]

Treatments

Conditions

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Procedures

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