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Cardiomyopathy Has Three Main Forms: Progressive cardiac muscle disease affects all ages

Cardiomyopathy is a progressive disease of the heart muscle. In this condition, the heart is abnormally enlarged, stiffened and/or thickened and weakened in its contractility. Sometimes scar tissue replaces the muscle tissues. This weakening or change in the heart muscle can lead to heart failure; irregular heartbeats called arrhythmias; blood clots; heart murmurs; cardiac arrest; and sudden death. Cardiomyopathy can be acquired or inherited, and it can affect people of all ages; however, people in certain age groups are more likely to have certain types of cardiomyopathy.

The three main types of cardiomyopathy are dilated, hypertrophic and restrictive. In dilated cardiomyopathy, the most common form of cardiomyopathy, the heart is weak and enlarged so it cannot pump blood efficiently. Different medical problems cause dilated cardiomyopathy. In the United States, nearly half a million people develop this condition every year.

Hypertrophic cardiomyopathy (HCM) is a condition where the heart muscle thickens, making it harder for the blood to leave the heart. This type of cardiomyopathy is normally passed down through families and is often present as a birth defect.

Restrictive cardiomyopathy is the least common form of the disease. It is a group of disorders where the heart cannot properly expand and fill with blood between heartbeats because the heart muscles are stiff.

Some people who develop cardiomyopathy have no signs and symptoms during the initial stages of the disease, but as the condition advances, signs and symptoms do appear. These may include dyspnea on exertion or shortness of breath; bloating of the abdomen due to ascites; dizziness and syncope; cardiac arrhythmias; and edema of the lower extremities.

Based on the particular case and its symptoms, a physician may recommend patients undergo an electrocardiogram, chest X-ray or echocardiogram, an MRI or advanced tests such as cardiac catheterization.

Most of the time, the cause of cardiomyopathy is unknown. However, possible causes include valvular or coronary heart disease; long-term, untreated hypertension; cardiac muscle damage from a previous myocardial infarction; chronic tachycardia; metabolic disorders such as diabetes or thyroid disease; severe obesity; and connective tissue diseases such as rheumatoid and lupus erythematosis. Other causes include nutritional deficiencies of essential minerals or vitamins such as vitamin B1, calcium, selenium and magnesium; pregnancy; excessive use of alcohol over many years; and abuse of antidepressant medications or cocaine. Cardiomyopathy may also occur due to the use of certain chemotherapy drugs. Viral infections may injure the heart and trigger cardiomyopathy and iron buildup in the heart muscle (hemochromatosis).

Cardiomyopathy can be treated, though the treatment depends on the type and how serious it is. Treatment may include changes in lifestyle and medications; surgically implanted devices; or, in severe cases, a heart transplant. Depending on the case, angiotensin-converting enzyme (ACE) inhibitors and beta blocker medications may be used to allow the heart to beat more efficiently, thus increasing cardiac output. If congestive heart failure symptoms exist, diuretics along with diet changes and salt restriction may be used to help prevent fluid retention and decrease the heart’s workload. When diagnosed early, treatment may prevent the disease from worsening.

To reduce the chance of heart failure, the physician may recommend the patient avoid conditions that may lead to a weak heart, such as controlling high blood pressure with diet and exercise and avoiding abuse of alcohol or cocaine. Other recommended lifestyle changes may include losing excess weight, smoking cessation and eating a well-balanced, low-sodium diet.

By Harleena Singh, Staff Writer

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