Cardiomyopathy is the technical term for acute and chronic diseases of the heart muscle. For the layperson, the causes of cardiomyopathy are almost unmanageable.
What is cardiomyopathy?
Cardiomyopathy is the medical term used to describe a wide range of heart muscle diseases. The term excludes the causative involvement of a valvular defect or the pericardium. The diverse manifestations of cardiomyopathy have led to various classifications in the field. Increasingly, however, a classification into 2 groups is becoming accepted:
1. primary cardiomyopathy: the underlying disease affects the heart muscle itself. 2. secondary cardiomyopathy: the underlying disease does not originate in the heart muscle, but is a regular or possible complication caused by a disease of one or more other organs. This definition does not take into account whether the cause is genetic or due to external factors. Both inherited and acquired myocardial disease are included in the spectrum of primary as well as secondary cardiomyopathy.
Causes
Primary cardiomyopathy is often the result of inflammation of the heart muscle (myocarditis). This includes the well-known influenza myocarditis and also autoimmune diseases in the course of pregnancy. Several causes, certainly including genetic factors, come together in the case of heart failure (myocardial insufficiency). Other cardiomyopathies are based exclusively on genetic defects of the heart muscle fibers or the neuronal cardiac conduction system. Secondary cardiomyopathies include conditions that are due to vitamin deficiencies or deficiencies of trace elements. Chemotherapies, stimulant toxins or heavy metals can also damage the heart muscle. Furthermore, diseases of the nervous system and rheumatic diseases can lead to secondary cardiomyopathies. Metabolic diseases often result in the deposition of waste products in various parts of the body. This also results in some of the secondary cardiomyopathies. Among hormonal disorders, hyperthyroidism and hypothyroidism are considered triggers, and diabetes is also known to cause cardiomyopathy.
Symptoms, complaints and signs
Cardiomyopathy often progresses for many years without symptoms. As the heart muscle disease progresses, symptoms increasingly set in, significantly affecting the performance and well-being of the affected person. Typical symptoms of cardiomyopathy include fatigue and physical exhaustion as well as shortness of breath during physical exertion. The shortness of breath is hardly noticed at the beginning and often subsides after a few minutes. Later, however, the breathing difficulties occur even at rest and thus lead to a strong feeling of unease, panic attacks or even fear of death. This is accompanied by chest pain, which is noticed mainly after eating, after drinking alcohol and during exercise, and later also becomes permanent. The lack of oxygen supply to the organs also leads to the development of fluid accumulation in the legs and lungs. As the disease progresses, cardiac arrhythmias and fainting may occur. Other possible consequences of cardiomyopathy include pulmonary infarcts, strokes and sudden cardiac death. Those affected can recognize heart disease by the typical, usually hard and irregular heartbeats. In addition, blood pressure fluctuations may occur, leading to dizziness and [[circulatory disorders9]]. If the disease is detected early and treated comprehensively, progression of symptoms can be prevented.
Diagnosis and progression
The physician will investigate for cardiomyopathy if symptoms such as shortness of breath, rapid fatigability, or dizziness are present. First, an ECG will indicate initial abnormalities, which may include cardiac arrhythmias. In some forms of cardiomyopathy, an enlargement of the heart is visible on an X-ray. An ultrasound examination provides insights into the beating heart (echocardiography). Finally, exploration with a cardiac catheter provides clues to the serious disease. Acute cardiomyopathies, for example, have a good chance of being cured. As a rule, however, cardiomyopathies are progressive degenerative diseases associated with a decrease in pumping capacity. In the final stage, cardiac arrest (sudden cardiac death) is often the result of cardiomyopathy.
Complications
Cardiomyopathy causes discomfort and disease of the heart muscle.In this case, the life expectancy of the affected person is usually limited and the patient may die from the symptoms if there is no timely treatment of these symptoms. In most cases, the patient’s exercise tolerance decreases significantly and the affected person suffers from shortness of breath. Certain activities or sporting activities are no longer possible due to the cardiomyopathy. Disturbances of the heart rhythm occur and, in the further course, cardiac insufficiency develops. If left untreated, this can lead to the death of the patient. Similarly, heart problems often lead to water retention in the legs or abdomen. Patients often suffer from dizziness or loss of consciousness. Without treatment, the patient may also experience sudden cardiac death. Treatment of cardiomyopathy is causal and depends on the underlying disease. As a result, the further course of the disease strongly depends on its manifestation, so that it is not possible to predict a general course of the disease. In some cases, transplantation of the heart is also necessary so that the affected person can continue to survive.
When should you see a doctor?
Individuals who notice recurrent shortness of breath or water retention in the legs may be suffering from cardiomyopathy. A visit to the doctor is indicated if the symptoms persist after a few days or if other symptoms are added. For example, cardiac arrhythmias and fatigue should be clarified quickly to avoid serious complications. People who also suffer from dizziness and impaired consciousness should call an emergency doctor or be admitted to hospital. The same applies to severe pain, skin changes and cramps. Cardiomyopathy often occurs in conjunction with heart muscle inflammation or heart failure. Vitamin deficiency, chemotherapy or the consumption of stimulants can also cause damage to the heart muscle. Anyone who considers themselves to be in one of these risk groups should consult their doctor. The family doctor can make an initial diagnosis and will then refer the patient to a cardiologist. Depending on the cause of the condition, a specialist in internal medicine, a sports medicine physician or a psychologist may also be consulted.
Treatment and therapy
Secondary cardiomyopathies are initially treatable as part of the underlying systemic disease. The goal is, for example, compensation for metabolic disturbances or detoxification for intoxications. Cardiomyopathies are treated with antibiotics and anti-inflammatory drugs. In any chronic case, the cardiologist will focus his efforts on the symptoms of the weakening heart and will initiate appropriate medication. Cardiac glycosides (digitalis) have long been used to strengthen the heart, and efforts are also made to lower blood pressure. The well-known beta-blockers lead to a relief of the heart. The direct consequences of cardiomyopathy are also the focus of treatment. Diuretic drugs must be prescribed to combat edema (water retention in the tissues). Antiarrhythmic drugs should eliminate the often occurring atrial fibrillation, sometimes only the implantation of a pacemaker helps. Anticoagulants reduce the risk of thrombosis and embolism. These are drugs for reducing the tendency of blood to clot, which are specifically intended to prevent strokes in the course of cardiac arrhythmias. If the course of cardiomyopathy with advanced heart failure threatens to become life-threatening, a heart transplant is often the only salvation. An artificial heart or electromechanical systems for cardiac support can keep the patient alive until a suitable donor heart is available. Despite the best efforts of modern medicine, many patients ultimately die as a result of cardiomyopathy.
Outlook and prognosis
In order to achieve improvement or even a significant slowing of the course of the disease, it is imperative that the treatment and therapy plan prescribed by a physician be followed precisely. Insofar as it is not a genetic cause of the disease, the patient himself can achieve an improvement in the quality of life with targeted measures and support the medical therapy. In cases where an unhealthy lifestyle with an unbalanced and often too sumptuous diet is the trigger of the disease, this must be urgently corrected. A change in diet has a positive effect on the circulation, relieves the heart and strengthens the immune system.This also makes it easier to achieve any weight reduction that may be necessary. The change should be accompanied by both the attending physician and a nutritionist so that it is best adapted to individual needs. In order to relieve the cardiovascular system, it is advisable to completely abstain from addictive substances such as alcohol and nicotine. The consumption of coffee should also be restricted and limited to a few cups per day. Regular exercise in everyday life, on the other hand, strengthens the circulation and improves fitness. Training with an ergometer or similar sports equipment is also beneficial. In the case of both acquired and disease-related causes, the avoidance of excessive stress is a crucial point, as this promotes the development of cardiomyopathy.
Prevention
Cardiomyopathy offers opportunities for prophylaxis, despite its multiple causes. Moderate consumption of stimulants such as alcohol or nicotine is advised here. Similarly, it is well known that exercise prevents several heart diseases at once. Inflammatory lesions should be checked by a doctor as soon as possible, especially flu and flu-like infections. Because from it sometimes results over the infection of the heart in the long run a cardiomyopathy.
Follow-up
In most cases, the options for aftercare in cardiomyopathy are very limited, so that those affected by this disease should ideally see a doctor at a very early stage so that early treatment can also be initiated. Self-healing cannot occur with cardiomyopathy, so a doctor should be contacted at the first signs or symptoms of the disease. Sufferers of this disease are usually dependent on taking various medications. The correct dosage and also the regular intake of the medication must be observed in order to properly alleviate the symptoms. If antibiotics are to be taken, they must not be taken together with alcohol, otherwise their effect will be significantly alleviated. Likewise, those with cardiomyopathy should undergo regular checkups and examinations by a physician to detect further damage to the heart at an early stage. Strenuous or stressful activities should be avoided in this disease. The further course of cardiomyopathy depends very much on the time of diagnosis. In some cases, the life expectancy of the affected person is reduced by this disease.
What you can do yourself
Patients diagnosed with cardiomyopathy should take the condition seriously and be sure to follow their doctor’s treatment plans and recommendations. In many cases, there are treatments that can improve the condition. In other cases, slowing or stopping the progression of the disease is entirely possible. For patients, this means that they must consciously adjust their daily lives to the demands of the disease. Cardiomyopathy is often the result of an unhealthy lifestyle. If an incorrect, unbalanced and usually overly sumptuous diet has been followed for years, a medically guided change in diet can have a positive effect on the heart and circulation. A weight reduction, which is sensible in many cases, also contributes to a better well-being in everyday life. Consumption toxins such as nicotine and alcohol should be avoided altogether if possible, and the consumption of coffee can be limited. Incorporating regular exercise into everyday life and thereby carefully strengthening the cardiovascular system and fitness usually has a beneficial effect on health. But these factors do not always trigger cardiomyopathy. Often it is simply genetic and occurs even though the patient has maintained a healthy and active lifestyle. Excessive stress, for example at work or in the family, promotes the development of the disease. Patients should be aware of these risks and avoid them as much as possible.
