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Cardiomyopathy
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Cardiomyopathy
literally means disease of the heart muscle.
Cardiomyopathy is a disease of the heart
muscle. This
leads to impairment of the heart's ability to pump
blood, and eventually to heart failure.
The name comes from the roots
cardio
meaning "heart,"
myo meaning "muscle" and
pathy meaning "disease." The known causes
of cardiomyopathy are many, and include coronary
artery disease and valvular heart disease.
Cardiomyopathy occurs in three major types:
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Dilated
cardiomyopathy. This type involves
enlargement of one or more of your heart's
chambers.
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Hypertrophic
cardiomyopathy. This form involves
thickening of your heart's muscle.
-
Restrictive
cardiomyopathy. This type results in
your heart muscle becoming more rigid.
You can take steps to reduce your risk of
developing cardiomyopathy. If you have the
condition, treatment depends on what type you have
and may include medications, implantable devices or,
in severe cases, a heart transplant.
Treatment
The overall goals of treatment for cardiomyopathy are to:
Treatment varies by which of the major types of cardiomyopathy you have:
-
Dilated
cardiomyopathy.
Doctors often prescribe medications for dilated cardiomyopathy.
Angiotensin-converting enzyme (ACE) inhibitors — such as enalapril (Vasotec)
or captopril (Capoten) — can improve the heart's pumping capability.
Diuretics, such as furosemide (Lasix), can reduce fluid retention.
Beta blockers — such as propranolol (Inderal) — can improve cardiac
function and reduce the risk of death in people with dilated
cardiomyopathy. Another option for some people with abnormal
electrocardiograms is a special pacemaker that coordinates the
contractions between the left and right ventricle (biventricular
pacing). In people who may be at risk of serious arrhythmias, drug
therapy or an implantable cardioverter defibrillator (ICD) may be
options. ICDs are small, minicassette-sized devices implanted in
your chest to continuously monitor your heart rhythm and deliver
precisely calibrated electrical shocks when needed to control
abnormal, rapid heartbeats. The devices can also terminate other
types of irregular heart rhythms.
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Hypertrophic
cardiomyopathy.
Your doctor may recommend beta blockers or calcium channel blockers
such as verapamil (Calan, Isoptin), which can relax your heart, slow
its pumping action and stabilize heart rhythms. For some people, a
pacemaker may improve symptoms. In advanced cases of hypertrophic
cardiomyopathy, a surgeon may remove a portion of the thickened
muscle wall that interferes with normal blood flow. This procedure,
called septal myotomy-myectomy, can reduce symptoms in most cases,
although as with any operation there are risks. Recent experimental
work has been done with a less invasive technique aimed at reducing
the obstruction to blood flow from the heart.
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Restrictive
cardiomyopathy.
Your doctor will recommend you pay careful attention to your salt
and water intake and monitor your weight daily. Treatment of fluid
retention is with diuretics.
Doctors often treat arrhythmogenic right ventricular dysplasia with
medications that control heart arrhythmias. These often include beta
blockers. Doctors also often advise people with ARVD to avoid strenuous
exercise.
Many of the medications that doctors prescribe for cardiomyopathy may
have side effects. Be sure to discuss these possible side effects with
your doctor before taking any of these drugs.
If you have advanced disease and medications can't adequately control
symptoms or when the prognosis for survival is particularly poor, a
heart transplant may be an option. Because of the shortage of donor
hearts, even people who are critically ill may have a long wait before
undergoing a heart transplant. In some cases, people can be supported
with a mechanical heart assist device as they wait for an appropriately
matched donor. These devices, known as ventricular assist devices (VAD),
can support the circulation for a prolonged period and may allow you to
live outside the hospital while you wait. In some people who aren't
candidates for a heart transplant, VAD therapy may provide long-term
support.
Cardiomyopathy
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