Does your heart feel weak? Let's talk about cardiomyopathy!

Do you sometimes feel very tired and short of breath? Do you feel dizzy even when climbing stairs? These may not be just random things. Maybe this is a condition that affects your heart muscle. We are going to talk about one such condition today, which is cardiomyopathy.

What is Cardiomyopathy?

Okay, so what is cardiomyopathy? Simply put, it's a disease that affects the muscle in your heart, the myocardium . Think of it like your heart is a pump. When you have this disease, your heart muscle can either become very thick, or it can get bigger, sometimes it can become stiff, and it can even form scar tissue.

So what happens when this happens? Your heart can't pump blood properly. That means your whole body doesn't get enough blood. Over time, the heart can become weaker and eventually lead to heart failure. But don't worry, there are treatments for this. Some people even end up having to have a heart transplant .

Are there different types of cardiomyopathy?

Yes, there are different types of cardiomyopathy. Let's look at that now.

• Dilated Cardiomyopathy: This is when the chambers of the heart (the chambers that fill with blood) become larger and the muscle walls become thinner. Like when a balloon is inflated, it becomes less able to pump blood.
• Hypertrophic Cardiomyopathy: This is when the heart muscle thickens excessively, causing less space inside the heart, making it harder for it to fill with blood and pump.
• Ischemic Cardiomyopathy: This is often caused by blockage of the coronary arteries that supply blood to the heart. This condition can also occur when the heart muscle is damaged, such as from a heart attack.
• Arrhythmogenic Right Ventricular Dysplasia (ARVD): This is a bit of a complicated name. This is where the muscle in the right ventricle of the heart is replaced by fatty tissue and fibrous tissue. It can also be caused by genetic factors.
• Restrictive Cardiomyopathy: In this condition, the heart muscle becomes stiff and loses its elasticity, making it unable to fill with blood properly.
• Transthyretin Amyloidosis Cardiomyopathy (ATTR-CM): In this, an abnormal protein called amyloid is deposited in the heart.
• Broken Heart Syndrome or Takotsubo Cardiomyopathy: This is a bit special. Imagine, when you suddenly experience great sadness, shock, or extreme mental stress, this condition can affect the heart.
• Chemotherapy-induced cardiomyopathy: This can also occur as a side effect of chemotherapy treatments for cancer.
• Alcohol-induced Cardiomyopathy: People who drink alcohol excessively are also at risk.
• Left Ventricular Non-compaction (LVNC): In this, the muscle in the left chamber of the heart becomes like a sponge.
• Peripartum Cardiomyopathy: This is a condition that can occur late in pregnancy or within a few months after childbirth.

How common is this disease?

Cardiomyopathy can affect people of all ages, genders, and ethnicities. The most common type, called hypertrophic cardiomyopathy , is a genetic condition that is passed down through generations. It is estimated that about one in 500 people in the world have it. Other genetic types affect about one in 2,000 or 2,500 people.

What are the symptoms?

Well, what symptoms does someone with cardiomyopathy show?

• Feeling very tired (Fatigue): Not just tiredness, but constant, unexplained fatigue.
• Heart palpitations: This can feel like a drum beating inside the chest, or like the heart is skipping a beat.
• Chest Pain: This is also a symptom.
• Heartbeat irregularities (Arrhythmia): This means that the heart's rhythm is disturbed.
• Difficulty breathing (Dyspnea): You may find it difficult to breathe even with a little exertion, or even just while standing.
• Swelling of the legs and ankles (Edema): This can occur due to water accumulation in the body.
• Fainting or loss of consciousness (Syncope): Sudden loss of consciousness and collapse are possible.

However, some people may have cardiomyopathy without showing any symptoms. They may not need treatment. However, symptoms only begin to appear as the disease progresses.

What are the causes of cardiomyopathy?

What are the causes of cardiomyopathy? One major cause is genetics . This means that the disease can be inherited from our parents. Researchers have identified thousands of genetic mutations associated with the disease.

Apart from that, there are several other reasons:

• Coronary Artery Disease .
• Autoimmune Diseases: For example, Connective Tissue Diseases.
• Infections (such as viruses, bacteria) that affect the heart muscle .
• Heart Inflammation .
• Diabetes `(Diabetes Mellitus)` .
• Thyroid Disease .
• Muscular Dystrophy .
• High cholesterol diseases .
• Sarcoidosis .
• Amyloidosis .
• Hemochromatosis: This is when excess iron accumulates in the body.

Sometimes, even specialists can't figure out why someone has cardiomyopathy. We call that idiopathic.

What are the risk factors?

What are the risk factors for developing cardiomyopathy? Some of these we cannot change.

• If anyone in the family has a history of heart failure, cardiomyopathy, or sudden cardiac arrest.
• If you have had heart attacks before.
• Long-term use of cocaine or alcohol.
• Pregnancy.
• A very stressful experience, like losing a loved one, for example.
• Receiving radiation or chemotherapy for cancer.
• Body Mass Index (BMI) greater than 30 (which means obesity).

What are the possible complications?

If this cardiomyopathy condition becomes severe, other heart problems may arise. These include:

• Heartbeat irregularities (Arrhythmias) .
• Heart Failure .
• Stroke .
• Heart Valve Disease .
• Cardiac Arrest .
• Cardiogenic Shock .

How is the diagnosis made?

So, how do you know for sure if you have cardiomyopathy? When you go to see a doctor, he or she will first ask about your medical history and whether anyone in your family has this condition. Then they will do a physical exam.

If they suspect you have a heart condition, they will refer you to a cardiologist. The cardiologist will do a full examination and, if necessary, do some more tests.

Diagnostic tests

• Ambulatory Monitoring: This involves wearing a small device for 24 hours or more to monitor the heart's function.
• Blood tests .
• Chest X-ray .
• Cardiac CT scan .
• Heart MRI `(Heart MRI)` .
• Echocardiogram: This is a very important test. It can look at many things like the size and shape of the heart, the thickness of the muscles, how it pumps blood, and the function of the valves.
• Electrocardiogram (EKG/ECG): This measures the electrical activity of the heart and can detect things like heart rhythm irregularities.
• Exercise Stress Test .
• Cardiac Catheterization .
• Myocardial Biopsy: Taking a small piece of heart muscle for examination.

What are the treatments?

Treatment for cardiomyopathy cannot completely cure the condition. However, symptoms can be managed and the disease can be controlled . Your doctor may recommend lifestyle changes, medications, various devices, or surgery.

Lifestyle changes

We can strengthen our hearts by making changes to the way we live our daily lives. Here are some things we can do:

• Eating a diet low in fat and salt.
• Maintain a healthy weight that suits you.
• Exercising regularly.
• Getting enough sleep.
• Reducing stress.
• Avoiding the use of tobacco products.
• Avoiding alcohol consumption.

It is very important to follow these things correctly, do you understand?

Medicines

Your cardiologist may prescribe medications such as:

• Antihypertensives .
• Anticoagulants (blood thinners)
• Antiarrhythmics are drugs that control heart rhythm irregularities .
• Cholesterol-lowering drugs.
• Aldosterone Antagonists .
• Corticosteroids (in some specific cases).

Devices to correct heart rhythm irregularities

• Pacemakers .
• Implantable Cardioverter Defibrillators (ICDs)

Devices to improve blood circulation

• Cardiac Resynchronization Therapy (CRT) .
• Left Ventricular Assist Device (LVAD) .

Surgery and other procedures

Doctors usually recommend open-heart surgery or a heart transplant only if all other treatments have failed. Rarely used procedures may include:

• Septal Myectomy .
• Heart Transplant .
• Alcohol Septal Ablation .
• Catheter Ablation .

How can I reduce my risk of cardiomyopathy?

You can take steps to protect yourself from things that can lead to cardiomyopathy.

• Controlling your blood pressure.
• Keeping cholesterol levels in a healthy range.
• Exercising regularly.
• Avoiding the use of tobacco products, alcohol, and cocaine.
• Controlling underlying medical conditions such as sleep apnea or diabetes.
• Going for regular medical checkups.
• Taking all prescribed medications as prescribed.

The important thing is that congenital (genetic) forms of cardiomyopathy cannot be prevented . But if you have cardiomyopathy, you can let your relatives know. They can then talk to their doctors to see if they are at risk or have the disease. Early diagnosis helps to develop a plan to manage the disease.

What happens if I have cardiomyopathy?

Cardiomyopathy is a serious condition. If left untreated, it can be life-threatening. It is also a progressive disease.

However, treatment for cardiomyopathy can improve your condition. If you have this condition, seek treatment from a cardiologist.

How long does cardiomyopathy last?

The length of time you have cardiomyopathy depends on the type you have. Takotsubo cardiomyopathy is usually temporary. Alcohol-induced cardiomyopathy may resolve in a few months. With other types, you will have to manage symptoms for the rest of your life.

Outlook for cardiomyopathy

There is no cure for cardiomyopathy. However, you can manage the condition or slow its progression. Many people with cardiomyopathy can live a good quality of life with a healthy lifestyle and medical care.

How do I take care of myself?

Lifestyle choices can affect how quickly cardiomyopathy progresses.

• Maintain a healthy weight for your height and age.
• Eating a heart-healthy diet, especially reducing sodium (salt) intake.
• Exercising regularly.
• Limiting alcohol consumption.
• Managing and reducing stress.
• Avoid smoking.

When should I see my doctor?

You will need regular medical checkups to monitor your heart health. Contact your doctor immediately if you experience any of the following:

• If new symptoms appear.
• If your symptoms get worse.
• If there are side effects from the medication.
• If there is a problem with a device you have (e.g. a pacemaker).

When should I go to the Emergency Department (ETU) ?

Seek emergency medical attention immediately if any of the following happens to you:

• Chest pain.
• Heart palpitations (fast or irregular heartbeat).
• Fainting or loss of consciousness.

What questions should I ask my doctor?

• What is the most likely cause of my cardiomyopathy?
• What kind of treatment do you recommend?
• What lifestyle changes should I make to improve my heart health?
• Is there a support group nearby or online that I can join?

It's normal to feel anxious about a diagnosis of cardiomyopathy. But doctors have many treatments that can improve your quality of life and help you live longer.

So, what are the most important things we should remember from this story?

Cardiomyopathy is a disease that affects the heart muscle, but it is nothing to be afraid of. If you are diagnosed early, treated properly, and follow a good lifestyle, you can live well with this condition. If you have any heart problems or symptoms, do not ignore them and see a doctor. Taking care of your heart is the most important thing. Remember, you are not alone, doctors and family are there to help!

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