Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, which makes it harder for the heart to pump blood to the rest of the body. The various types of the disease have many causes, signs and symptoms as well as treatments.

In most cases, cardiomyopathy causes the heart muscle to become enlarged, thick or rigid. In more rare instances, diseased heart muscle tissue is replaced with scar tissue.

As the disease worsens over time, the heart becomes weaker, therefore making it even more unable to pump blood throughout the body and maintain a normal electrical rhythm. This can result in heart failure or arrhythmias. A weakened heart also can cause other complications, like valvular problems.

Presentation

• SOB

• Lightheadedness

• Faint

• Palpitations

• Chest pain or discomfort

Causes

Most are congenital, but the minority can be due to:

• HTN

• MI

• Arrhythmias

• Valvular disease

• Haemochromatosis, Amyloidosis, Alcohol abuse

Types

• Hypertrophic cardiomyopathy (HCM) - LV Hypertrophy without an identifiable cause. An ECHO is done to assess this. If there is an obstruction to LV outflow at rest, then it’s classed as HOCM (Hypertrophic Obstructive Cardiomyopathy), which requires treatment.

• Dilated cardiomyopathy - LV dilates, stretches, and becomes thinner before spreading to the RV and atria. As the chambers dilate and its walls stretch, the muscle can’t contract normally, and the conduction pathways become affected. This can lead to heart failure, arrhythmias, and valvular issues.

• Restrictive cardiomyopathy - Ventricles become rigid as scar tissue replaces the normal muscle. As a result, the ventricles can’t relax normally to fill with blood, therefore backlogs and enlarges the atria. This can lead to heart failure and arrhythmias.