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What Is Dilated Cardiomyopathy?

Dilated cardiomyopathy is a disease of the heart muscle that prevents the muscle from producing the normal force of contraction. Therefore the heart cannot pump enough blood to the organs in the body. The heart becomes weaker and the four heart chambers get larger (dilate). These chambers are the atria (upper chambers) and ventricles (lower chambers). The heart muscle may thicken so that it can produce more force to keep blood pumping normally. The heart valves may also be affected as the heart chambers get large, which may worsen the flow of blood. The impaired heart action can affect lungs, liver, and other organs.

More men (about three times as many) than women have cardiomyopathy, and more African Americans (about three times) than whites.

What Causes Dilated Cardiomyopathy?

The cause is usually unknown. Factors that damage the heart muscle and lead to heart failure can cause it. These factors include coronary artery disease, poorly controlled diabetes, anemia, and valvular heart disease. Harmful chemicals (such as alcohol), infections, medications, cocaine, heroin, and some connective tissue diseases may also cause it. Cardiomyopathy often cannot be prevented, but avoiding harmful chemicals such as alcohol may reduce the risk of getting it.

What Are the Symptoms of Dilated Cardiomyopathy?

Most people feel tired (fatigue), less able to exercise, or short of breath. Swelling of the legs or feet, chest pain, fast heart beat, and palpitations (feeling that the heart skips beats) may also occur.

How Is Dilated Cardiomyopathy Diagnosed?

The health care provider will ask about symptoms, do a complete physical examination, and order tests. Electrocardiography (ECG) and chest x-rays, which can show an enlarged heart, will be done. The health care provider will suggest seeing a heart specialist (cardiologist) for additional tests. Echocardiography (ultrasound examination of the heart) or angiography (special x-ray examination to check blood flow through the heart) may be done to determine how much damage is present.

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How Is Dilated Cardiomyopathy Treated?

Therapy is aimed at relieving symptoms and correcting abnormal heart rhythms (arrhythmias). Lowering salt intake and resting are important. A heart valve operation may be needed for damaged valves. If the cause of the cardiomyopathy is known, that condition is treated. The health care provider may prescribe medicines to control the heart rhythm (antiarrhythmics) and dilate blood vessels (vasodilators), water pills (diuretics), and nutritional supplements. A cardioverter defibrillator may be inserted in the chest in people responding poorly to medications. If the heart’s pumping action is seriously impaired and symptoms of heart failure get worse, heart transplantation can be considered for young people.

DOs and DON’Ts in Managing Dilated Cardiomyopathy:
  • DO lower the amount of sodium (salt) and fluid in your diet.
  • DO take all medicines as prescribed.
  • DO call your health care provider if you have new or worsening chest pain, shortness of breath, swelling in the legs, or fainting.
  • DON’T drink alcohol.
  • DON’T do strenuous exercise until your health care provider says that you can.
  • DON’T abuse drugs. Cocaine, heroin, and organic solvents such as glue can cause dilated cardiomyopathy.
FOR MORE INFORMATION

Contact the following source:

  • American Heart Association
    Tel: (800) 242-8721
    Website: http://www.americanheart.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor

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What Is Hypertrophic Cardiomyopathy?

Hypertrophic cardiomyopathy (also known as HCM, IHSS, hypertrophic obstructive cardiomyopathy) is an illness affecting the heart muscle. It interferes with the heart’s ability to pump blood. Sometimes it also changes the heart’s natural rhythm, which leads to irregular heartbeats (arrhythmias).

One type of cardiomyopathy, hypertrophic cardiomyopathy, occurs when the heart’s muscle fibers grow abnormally. Heart walls thicken, especially in the left ventricle (the main pumping chamber). The left ventricle becomes smaller inside, the heart cannot rest completely between beats, and the ventricle pumps less blood out of the heart. People are at risk for fainting (syncope), chest pain (angina), difficulty breathing (dyspnea), and sudden death.

Hypertrophic cardiomyopathy affects people of all ages, including children. It can cause sudden death even in children and young adults.

What Causes Hypertrophic Cardiomyopathy?

Hypertrophic cardiomyopathy is usually inherited (passed on from parents). Once someone is diagnosed, all immediate family members should be tested. The cause in some elderly people may also involve long-standing untreated high blood pressure (hypertension).

What Are the Symptoms of Hypertrophic Cardiomyopathy?

Symptoms include shortness of breath when walking, performing household tasks, or with any exertion; chest pain; fainting after exercising; and irregular or very rapid heartbeat. Some people have no symptoms, and sudden cardiac arrest may often be the first sign of this disorder.

How Is Hypertrophic Cardiomyopathy Diagnosed?

The health care provider will check the medical history and do a physical examination. Tests for diagnosis include chest x-rays, electrocardiogram (ECG), and echocardiography (ultrasound of the heart). Other tests, such as 24-hour recording of the heartbeat and blood tests may also be done. Genetic testing using a blood test and magnetic resonance imaging (MRI) of the heart may also be done.

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How Is Hypertrophic Cardiomyopathy Treated?

Treatment is aimed at controlling symptoms and slowing the disease progress by reducing excessive contractions of the ventricle. Symptoms of heart failure and arrhythmias are also treated. Drugs are usually prescribed to regulate the heart rate and strength of contractions. These drugs include beta-blockers (e.g., propranolol) and calcium channel blockers (e.g., verapamil). A pacemaker/defibrillator/cardioverter is an option to control the heartbeat. It is a small device that is put into the body during surgery. Surgery may also be done to remove part of the abnormal muscle (septal myectomy) and reduce the blockage of blood flow. Destruction of a portion of the wall between ventricles (alcohol septal ablation) may also be done. Heart transplantation is possible for people who don’t respond to other treatments.

DOs and DON’Ts in Managing Hypertrophic Cardiomyopathy:
  • DO take medicine as prescribed by your health care provider.
  • DO tell your health care provider if your symptoms get worse or don’t improve with treatment.
  • DO remember that family members should be checked for this disorder.
  • DO call your health care provider if you have new or worsening chest pain, shortness of breath, swelling in the legs, or fainting.
  • DON’T change your exercise program without telling your health care provider first.
  • DON’T take over-the-counter drugs, foods, or herbal supplements before checking with your health care provider because they may react with your heart medicine.
  • DON’T smoke.
  • DON’T drink alcohol.
  • DON’T use diuretics (water pills).
FOR MORE INFORMATION

Contact the following sources:

  • American Heart Association
    Tel: (800) 242-8721
    Website: http://www.americanheart.org
  • American College of Cardiology
    Tel: (800) 253-4636
    Website: http://www.acc.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor

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What Is Restrictive Cardiomyopathy?

Restrictive cardiomyopathy is a disease of heart muscle that prevents the muscle from contracting (squeezing) with normal force. The result is that the heart doesn’t pump blood well. Restrictive cardiomyopathy means that the heart has a restricted ability to contract because the inner lining of the heart becomes stiff. The heart does not expand properly when it fills. The heart muscle thickens to make more muscle so it can increase its strength of contraction, but due to the abnormal filling of the heart is unable to function normally.

This type of heart disease is much less common than heart disease from coronary artery disease or heart valve problems.

What Causes Restrictive Cardiomyopathy?

Most of the time the cause is unknown. Amyloidosis, a condition in which abnormal deposits of protein in some body tissues occur, may be a cause. Sarcoidosis, a condition involving abnormal inflammation of lymph nodes and other tissues, may be another cause. It may also be caused by inflammatory or autoimmune conditions. Drinking alcohol in excess can make it worse.

What Are the Symptoms of Restrictive Cardiomyopathy?

Most people have tiredness, less ability to exercise, and shortness of breath. Swelling in the legs or feet, chest pain, or palpitations (feeling that the heart is skipping or beating too fast) may also occur. Cardiomyopathy can cause heart failure.

How Is Restrictive Cardiomyopathy Diagnosed?

The health care provider may suspect the disorder on the basis of the medical history and physical examination. The health care provider may also order electrocardiography (ECG) and chest x-rays. These tests usually show an enlarged heart. ECG may also show an irregular heartbeat (arrhythmia). Echocardiography (ultrasound examination of the heart) may be done to check the heart’s pumping action. Blood tests may also be done to look for other causes.

In some cases, cardiac catheterization and biopsy of heart tissue may be done to confirm the diagnosis.

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How Is Restrictive Cardiomyopathy Treated?

Therapy is aimed at relieving symptoms of heart failure and correcting abnormal heart rhythms (arrhythmias).

Medications known as diuretics reduce fluid in the blood to decrease the work of the heart.

The health care provider may prescribe drugs that regulate the heartbeat or drugs that suppress immune function (corticosteroids) to fight conditions causing the cardiomyopathy.

If the heart’s pumping is very poor and symptoms of heart failure worsen, heart transplantation may be needed.

DOs and DON’Ts in Managing Restrictive Cardiomyopathy:
  • DO eat a low-salt diet to reduce fluid accumulation.
  • DO take all your prescribed medicines as directed.
  • DO exercise when your health care provider says that you can.
  • DO call your health care provider if you have new or worsening chest pain, shortness of breath, swelling in the legs, or fainting.
  • DON’T drink alcohol.
FOR MORE INFORMATION

Contact the following sources:

  • American Heart Association
    Tel: (800) 242-8721
    Website: http://www.americanheart.org
  • American College of Cardiology
    Tel: (800) 253-4636
    Website: http://www.acc.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor