What is it about ?
Cardiomyopathy is a condition of the muscle of the heart (myocardium). The heart is less able to contract or relax. As a result, it pumps blood less well. The pumping function of the heart is therefore reduced, and blood circulates less well in the body. When this causes the heart to dilate, it is called dilated cardiomyopathy.
“Cardiomyopathy” is the generic term for all diseases of the heart with dilation of the heart muscle and therefore the ventricles of the heart. It can have different causes:
- hereditary diseases (30% of cases);
- a viral infection of the muscle of the heart (myocarditis) ;
- systemic diseases, such as lupus, rheumatic affections…;
- toxic substances, such as certain drugs (eg. chemotherapy in case of cancer), excessive alcohol consumption over a long period of time;
- metabolic diseases, such as lazy thyroid or a overactive thyroid, the diabetes, the’obesity…;
- cardiomyopathy that develops in late pregnancy or during the period of motherhood.
If no cause is found, it is called idiopathic cardiomyopathy.
What is its frequency?
The condition affects 42 in 100,000 adults. It is very rare in children. Cardiomyopathy is more common in some families, because a hereditary predisposition may play a role.
Certain eating habits can increase the risk of cardiomyopathy, such as excessive and prolonged alcohol consumption.
How to recognize it?
For a long time, no symptoms appear, and heart disease is often discovered by chance. On an x-ray of the lungs, for example, it can be seen that the heart is bigger.
In the longer term, a heart failure. Frequent symptoms are thenshortness of breath to the effort and heart rhythm disturbances. At a more advanced stage, theheart failure will cause water to accumulate (edema). When the edema reaches the lungs, the’shortness of breath is much more pronounced. The accumulation of fluid in the tissues usually begins with a swelling of the legs and weight gain.
Sometimes the first symptom is a stroke or a increased pulse.
How is the diagnosis made?
The doctor will suspect cardiomyopathy if there isheart failure and of heart rhythm disturbances. However, many other heart conditions can also explain these problems. Therefore, the diagnosis of cardiomyopathy is a so-called exclusion diagnosis. This means that the doctor will first rule out all other causes ofheart failure and of heart rhythm disturbances, like a heart attack (infarction), damage to the valves of the heart, hypertension… This is why he will always ask for additional examinations.
The first technical examinations are a blood test, an x-ray and a ultrasound of the heart (echocardiography). The x-ray usually shows an enlarged heart shadow. Echocardiography is used to visualize the size of the heart ventricles, the thickness of the myocardium and the valves of the heart, as well as to calculate the heart function.
On an ECG (tracing of the electrical activity of the heart), the doctor may see an enlargement, heart attack and one heart rhythm disorder. A coronary angiography or coronary angiography is also often performed; a catheter is inserted into a blood vessel in the groin and pushed into the heart to see any narrowing of the coronary arteries of the heart.
If necessary, the doctor may take a small piece of heart muscle for examination under a microscope (biopsy).
What can you do ?
In case of’shortness of breath, chest pain,edema in the legs or heart palpitations, it is better to have you checked by a doctor.
Try to adopt a healthy lifestyle: get enough exercise (without strenuous effort), limit your alcohol intake, stop smoking, and try to lose weight if you are overweight.
It may be helpful to write down your weight in a journal several times a week to help you notice fluid retention more quickly.
It is very important that you take your medication correctly and that you contact your doctor if you have any questions.
What can your doctor do?
Treatment should target the underlying cause, if possible.
In the presence of signs ofheart failure, the doctor will prescribe a drug that supports the pumping function of the heart. Often times, diuretics will be prescribed so that you can remove excess fluid from your body.
If there is an increased risk of blood clots, as in the case of heart rhythm disturbances, anticoagulants are prescribed.
In case of heart rhythm disturbances serious, a pacemaker or a defibrillator may be implanted in the heart. To avoid sudden death due to heart rhythm disturbances, an automatic implantable defibrillator (ICD) can be used. It restores the heartbeat by automatic electric shock.
A heart transplant is usually only considered if theheart failure causes severe symptoms, gets progressively worse despite treatment and the person is under 60 years of age and otherwise in good health.
Want to know more?
www.mongeneraliste.be/nos-dossiers/maladies-cardiovasulaires-infarctus-avc-arthmie-cardiaque
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