What is Cardiomyopathy and Why Should We Care?

Introduction

Do you know anyone who has experienced heart disease? Cardiomyopathy is a type of heart disease characterized by the stiffening of the heart muscle. This deterioration of the heart muscle reduces its ability to pump blood as efficiently. In the United States, cardiomyopathy affects 1 in 500 adults. Unlike other heart diseases, cardiomyopathy may affect younger people, including people aged 20 years old and older. It can cause heart failure if not treated. Cardiomyopathy has been categorized into four main types. Some of these types of cardiomyopathy can be reduced through precautions and lifestyle modifications.

 

Causes/ Risk Factors 

According to the National Institute of Health (NIH), general risk factors for cardiomyopathy include family history of cardiomyopathy, diabetes, and existing heart conditions (NIH). Long-term alcoholism and consistent high blood pressure are other risk factors and are recognized as causes of certain types of cardiomyopathy, such as dilated and diabetic cardiomyopathies (NIH). For many cases of cardiomyopathy, the causes are unknown, and the etiology (cause) of the disease can differ depending on the different types of the disease. 

 

Symptoms

There are many symptoms depending on the age and gender of the person. Some general symptoms to be aware of include fatigue, fainting, swollen legs and ankles, irregular heartbeats, and shortness of breath. However, some may not experience any symptoms at all.

 

The Main Types of Cardiomyopathy

 

There are four main types of cardiomyopathy: dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, and arrhythmogenic right ventricular dysplasia. Figure 1 below shows the difference in some of these types when it comes to how it affects the heart’s structure. Each type of cardiomyopathy has different causes and risk factors, and the two most common types will be summarized below.

Npatchett, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons

Dilated cardiomyopathy is regarded as the most common type of cardiomyopathy by Cleveland Clinic and Johns Hopkins Medicine. Dilated cardiomyopathy is characterized by the expansion of a ventricle, which restricts the ability of the muscle to pump effectively and relax afterward. The most common type of dilated cardiomyopathy is ischemic cardiomyopathy ( insufficient blood supply to heart muscle caused by coronary heart disease and heart attacks) . This is shown in Figure 2, which also compares how a heart affected by dilated cardiomyopathy compares with a normal heart. According to “Cardiomyopathy” from Johns Hopkins Medicine, this type generally affects adults from the ages of 20 to 60. 

BruceBlaus, CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, via Wikimedia Commons

Hypertrophic cardiomyopathy affects 1 in 500 Americans (Columbia Cardiology, 2020). As its name suggests, hypertrophic cardiomyopathy involves hypertrophy – the thickening of the ventricles of the heart as shown in Figure 3. With hypertrophic cardiomyopathy, there are higher chances for a patient inheriting it from family compared to other types as about 50 percent of cases are caused by genetics (Columbia Cardiology, 2020). 

Blausen Medical Communications, CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, via Wikimedia Commons

Preventive Strategies

Some people with cardiomyopathy may never show any symptoms. However, others could have significant symptoms or complications such as the ones listed above in the symptoms section. This may require treatment to get better. 

 

If an individual suspects that they have a family history of heart disease or a history of high cholesterol, a healthcare provider will work with them to document their family medical history to determine if there is a pattern of heart disease. Then, they will  determine whether the individual is eligible for genetic testing. In addition to being more aware of their health risks, a benefit of getting genetically tested for cardiomyopathy is that if an individual has the gene for the disease, they can recommend close family members to get the same genetic testing. A genetic counselor can educate them about the process and help them and their family understand the results and plan the next steps (AHA). 

 

If an individual is diagnosed with cardiomyopathy or at a greater risk of getting this condition, their doctor may suggest a few changes in their diet, physical activity, lifestyle, and medications. There are a few preventive measures one can take to reduce their chances of developing cardiomyopathy or other heart diseases. These include visiting their doctor for frequent checkups or testing, following their doctor’s recommendations and suggestions about making changes to their lifestyle, and taking all of their doctor’s prescriptions and medications (for other conditions/illnesses, so they don’t harm an individual’s health or raise their chances of cardiomyopathy). 

 

To lower the risk of developing heart disease in general, some lifestyle modifications as suggested by American Heart Association include:

  • Quitting smoking
  • Losing weight 
  • Avoiding alcohol and illegal substances 
  • Getting sufficient sleep and rest
  • Minimizing stress 
  • Incorporating a healthy diet and physical activity into daily routine 
  • And treating underlying conditions, such as diabetes and high blood pressure

 

References

American Heart Association. (n.d.) Prevention and treatment of cardiomyopathy. Retrieved    December 11, 2021, from https://www.heart.org/en/health-topics/cardiomyopathy/     prevention-and-treatment-of-cardiomyopathy. 

CDC. (Dec 9 2019). Cardiomyopathy. Retrieved from   https://www.cdc.gov/heartdisease/cardiomyopathy.htm.

Division of Cardiology. (2020, October 12). Genetic testing. Retrieved December 11, 2021, from 

https://www.columbiacardiology.org/patient-care/hypertrophic-cardiomyopathy-center/about-hypertrophic-cardiomyopathy/genetic-testing. 

John Hopkins Medicine. (n.d.). Cardiomyopathy. Retrieved from 

https://www.hopkinsmedicine.org/health/conditions-and-diseases/cardiomyopathy

NIH. (n.d.). Cardiomyopathy. Retrieved from https://www.nhlbi.nih.gov/health/cardiomyopathy