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Cardiomyopathy: Causes, Symptoms, And Treatment

You all must be known about cardiomyopathy. If not, then this article will be beneficial for you. I will be discussing cardiomyopathy and its signs, its types, and signs. Further, you will get facts about ischemic cardiomyopathy, peripartum cardiomyopathy, and hypertrophic obstructive cardiomyopathy and will be known about their symptoms. 

Cardiomyopathy is known as thickness, stiffing of heart muscles. This made our heart muscles hard and made it difficult to pump the blood. Cardiomyopathy often leads to heart failure. In a condition of cardiomyopathy, the heart becomes very rigid than normal. 

What is cardiomyopathy?

Cardiomyopathy is an unknown type of disease. Sometimes people with cardiomyopathy live a long and healthy life without even knowing it. And in some cases, it can cause severe complications and symptoms. 

The more cardiomyopathy complicates, the weaker the heart becomes. The heart becomes unable to maintain the rhythm and causes arrhythmias. This condition develops valve problems. Not just valve problems, but because of this, in turn, the fluids start to accumulate in the lungs, abdomen, legs, or ankles. 

The causes of cardiomyopathy are often unknown. It is either inherited or acquired.

  1. Inherited means that the person has got this disease gene from his family or ancestors. 
  2. Acquired means that the person had developed this disease from some other disease or condition.

Cardiomyopathy does not need any specific age to develop. It affects people of all ages. But mainly affects the adults or people of certain age groups. 

Signs and symptoms of cardiomyopathy:- 

As I told above that in some cases, people don’t even realize that they have cardiomyopathy and continue living with it without any noticeable symptoms. But some people have visible severe symptoms, and the condition worsens rapidly. Usually, in the beginning, people do not experience symptoms at an early age. But after some time they notice symptoms like

  • SOB (shortness of breath).
  • Chest pain and discomfort.
  • Difficulty in breathing, especially after any physical activity.
  • Arrhythmias. 
  • Tiredness and fatigue.
  • Swelling or fluid buildup in the abdomen, feet, ankles, and veins around the neck.
  • Dizziness and light-headedness. 
  • Cough. 
  • Fainting after exercise or any physical exertion.
  • Heart murmurs. 

Some people develop these symptoms quickly while others don’t. If it is not treated at the right time the condition can get worse and even cause heart failure. 

What is Ischemic cardiomyopathy?

The result of coronary heart disease or heart attack is ischemic cardiomyopathy. In this condition, the heart muscles are very weak. In ischemic cardiomyopathy, the left ventricle becomes weak and enlarged. This stops the heart to pump efficient blood to the body and further causes heart failure. 

After findings and diagnosis, in the first place, doctors recommend a change in lifestyle, diet, medications, and surgeries are performed to sustain the heart and to prevent more complications. A healthy and balanced lifestyle contributes so much in maintaining a healthy, lowering chance of diseases, and preventing the risk of symptoms. 

Symptoms of ischemic cardiomyopathy:- 

In an early stage of ischemic cardiomyopathy, it is possible to have no noticeable symptoms. But with the time as the left ventricle becomes more dilated and loses the ability for pumping, effective blood following symptoms may start to experience by the person. In this condition, the blood flow is impaired due to a decreased volume of pumping blood. 

  • Shortness of breath.
  • Swelling in the legs (Oedema).
  • Swelling in the abdomen.
  • Extreme fatigue, inability to exercise, or continue daily routine activities.
  • Angina pectoris which means chest pain or pressure that occurs with any physical activity and can also occur with rest or after meals.
  • Cough, and congestion due to fluid retention.
  • Weight gain.
  • Palpitations or fluttering in the chest due to arrhythmias.
  • Dizziness and lightheadedness.
  • Fainting because of irregular heart rhythms and abnormal responses of the blood vessels during exercise, without any cause. 
  • Sleep disturbance. 

If any person is experiencing episodes of such symptoms or having angina, then report to the nearest hospital. 

What are the causes of ischemic cardiomyopathy?

As told above that ischemic cardiomyopathy is mainly caused by heart attacks and coronary heart disease. Major causes for Ischemic cardiomyopathy are:

  • Family history.
  • Past medical history of heart attack or coronary disease.
  • Bad lifestyle. 
  • High blood pressure
  • Diabetes. 
  • High cholesterol. 
  • Obesity. 
  • Smoking. 
  • Kidney diseases. 
  • Amyloidosis. 
  • Abusive use of Drugs.
  • High intake of alcohol. 
  • Intake of oral contraceptives. 

Ischemic cardiomyopathy is more likely to be diagnosed in males. Still, after menopause, if the female smokes or has any other above mentioned condition, she is also at risk of developing ischemic cardiomyopathy. 

Step after diagnosis:- 

If you experience certain symptoms with suitable causes, you should rush towards the hospital because it can be lethal if it worsens. The person must get reported to a professional cardiologist. 

After the physical examination, the cardiologist may order some diagnostic tests if he suspects it. Such tests are:

  • Blood tests.
  • Imaging tests, including CT Scan, MRI, X-ray.
  • ECG.
  • Echocardiogram. 
  • Angiogram.
  • Stress test. 
  • Cardiac catheterization. 
  • And myocardial biopsy to confirm the suspicion. 

Next, for the treatment, the physician may recommend a combination of lifestyle changes, a combination of medications, surgery, and procedures. Such choices will help lower the risk of complications and reduce the chances of developing ischemic cardiomyopathy or worsening it. 

The procedures required are:-

  • Atherectomy.
  • Implantation of pacemakers. 
  • Angioplasty. 
  • Insertion of a stent. 
  • Radiation therapy. 
  • CABG (Coronary Artery Bypass Grafting).
  • Heart transplant.

Doctors recommend heart transplant and CABG as the final and last option when there is no option left or nothing is working for saving the patient. These procedures are risky and beneficial on the same table. 

Peripartum cardiomyopathy (PPCM):-

Postpartum cardiomyopathy or peripartum cardiomyopathy is defined as the weakness of the heart muscle after almost 5 months of delivering the baby. It is a rare condition which happens sometimes just after the delivery. And has no known cause. Sometimes the symptoms are visible and severe but in some cases, it is hidden and mild. 

This rare disease has a high recovery rate. In some women, if their ejection fraction (The rate of the blood heart pumps out in each beat) is lower than 60% they can still recover from this. And sometimes with a matter of time, it gets recovered. 

Symptoms and signs:- 

The symptoms of peripartum cardiomyopathy are most likely than that of heart failure. People get confused, whether it is peripartum cardiomyopathy or heart failure. Sometimes it is not diagnosed because there are no such symptoms in the beginning. The severity of the symptoms depends on the classes that are:

  1. Class 1:- No symptoms. 
  2. Class 2:- Mild symptoms or symptoms after extreme physical exertion.
  3. Class 3:- Symptoms after a little activity or normal routine activities. 
  4. Class 4:- Severe symptoms. At rest or any position. 

Some common symptoms for peripartum cardiomyopathy are:

  • Fatigue. 
  • Skipping heartbeat. 
  • Nocturia (frequent nighttime urination.
  • SOB with or without activity or when at rest.
  • Swelling in legs, ankle, and veins of the neck.
  • Low blood pressure. 
  • Rapid palpitations. 
  • Tiredness. 

These symptoms vary from woman to woman. And depends on the class. These range from mild to severe. 

What are the risk factors and causes of PPCM? 

Women who are at risk of developing peripartum cardiomyopathy are the ones who smoke heavily or have a high intake of alcohol after delivery or before having a child. It is more common in women who conceive a child after 30 or 35 years of age and also took oral contraceptives. Many other risk factors are:

  • Obesity.
  • High blood pressure. 
  • Gestational diabetes. 
  • History of myocarditis. 
  • Malnutritional women.
  • Premature deliveries. 
  • Use of medications like antidepressants, contraceptives. 

The causes of peripartum cardiomyopathy are unclear and unknown. But some of the defined causes are:

  • Coronary artery spasm. 
  • Small vessel disease. 
  • Abnormal immune response. 
  • Defective antioxidant defenses. 
  • Genetics or inherited. 

There’s no definite cause of peripartum cardiomyopathy. However, doctors believe that this condition develops when the extra pumping of blood combines with other risk factors of the disease. This combination puts more stress on the heart. 

Treatment and diagnosis:- 

After experiencing symptoms, then see a professional and report your condition to him. Because sometimes, it is difficult to diagnose PPCM. For diagnosis, the doctor will perform a physical examination and find for fluid in the lungs. Then some of the diagnostic tests are performed that are:

  • Listening heart sounds with a stethoscope. 
  • Blood pressure test. 
  • Myocardial biopsy.
  • X-ray. 
  • CT scan. 
  • Nuclear heart scan.
  • Echocardiogram. 
  • Kidney, liver function tests.
  • Tests for assessing electrolytes.
  • Complete blood count.
  • Markers for cardiac injury. 

The main objective of treating Peripartum cardiomyopathy is to keep the lungs away from the accumulation of excess fluid. The Doctor recommends a balloon heart pump in severe cases. The heart damage in PPCM is irreversible. But, the heart can still function for a long time, hidden, with the presence of disease. It depends on the severity of the damage. The severity of the damage will determine whether a heart transplant is needed or not. Transplantation is the final and last step. 

In last: 

Both of the conditions for cardiomyopathy, one is for male and second for women. Preventions for these diseases and maintaining the health of the heart are more likely common. That is:

  • Low-fat, balanced diet.
  • Exercising regularly.
  • Avoid smoking, alcohol, drug use.
  • Maintain a healthy lifestyle.
  • Monitoring blood pressure and cholesterol levels.

Some important tips you should take with any type of disease is:

  • Do not medications without prescriptions.
  • Do not ignore the symptoms. 
  • Do not wait to get severe symptoms but report to a physician and get yourself checked. 

In these cases,  heart transplantation is trusted for preserving longevity.

FAQs:-

Which type of medications are required in ischemic cardiomyopathy?

A combination of beta-blockers, calcium channel blockers, aldosterone inhibitors, Diuretics, blood thinners are mainly prescribed to the person suffering from ischemic cardiomyopathy. Medications for controlling blood pressure, cholesterol, and heart rhythm are also a choice. 

What happens if Ischemic cardiomyopathy is left untreated?

If it is left untreated or the person lacks proper nutrition and do not take medications on time or miss routine checkups and doesn’t listen to the doctor’s advice and not make a healthy choice, he is much likely to develop blood clots and then heart failure and even cause death. 

Which type of medications is required for postpartum cardiomyopathy?

The medications needed for treating postpartum cardiomyopathy are:
ACE Inhibitors. 
Beta-blockers. 
Anticoagulants. 
Diuretics.
Digitalis.

Does PPCM affect pregnancies?

If a woman developed PPCM during pregnancy, there are chances of developing it again in future pregnancies or pregnancies after 30-35 years. It can develop severe symptoms in further pregnancy and can also be inherited.

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