Having a ‘big heart’ may be a great thing in metaphorical terms but in literal cases, it is a serious medical condition. Enlargement of the heart muscles is known as cardiomyopathy. Cardiomyopathy is actually a group of conditions that affect the ability of the heart muscles to pump blood.
The human heart consists of four chambers- two atria and two ventricles. The atria receive blood and the ventricles pump blood out of the heart. These chambers are made of a special type of muscle called cardiac muscle. Cardiomyopathy affects the size and shape of the heart muscles.
Cardiomyopathy can involve stiffening of the heart muscles, thickening of the muscles, or stretching of the cardiac muscles.
Types Of Cardiomyopathy
Cardiomyopathies are of four main types: dilated cardiomyopathy, hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia, and restrictive cardiomyopathy.
This is a type of condition in which the heart muscles become thin and stretched which makes them weak and unable to pump blood adequately. This is the most common type of cardiomyopathy.
Thinning of the heart muscle causes enlargement of the heart. The weakness of the heart can lead to heart failure.
This is a genetic form of cardiomyopathy in which there is thickening of the heart muscles which restricts the flow of blood through the heart and from the heart to the rest of the body. The thickening of the walls of the heart means that the heart can’t hold as much blood as it should be able to.
Hypertrophic cardiomyopathy often goes undiagnosed but it is a leading cause of sudden cardiac arrest in young people.
Arrhythmogenic Right Ventricular Dysplasia
In this type of cardiomyopathy, the cardiac muscle of the ventricles is replaced by fat and fibrous tissue. This is a rare form of cardiomyopathy.
Loss of cardiac muscle cells can lead to heart failure and abnormal heart rhythms. This type of cardiomyopathy is called by a mutation in the genes that control proteins that produce cardiac cells. This causes cell death of the cardiac muscle cells and the dead cells are replaced by fibrous tissue and fat.
In restrictive cardiomyopathy, the walls of the ventricles stiffen and are unable to relax. This affects the pumping of blood out of the heart. It is the least common form of cardiomyopathy.
The cause is unknown but it can be caused by scarring after a heart transplant or it may be an inherited condition.
Other types of cardiomyopathy include stress cardiomyopathy, secondary cardiomyopathy, and ischemic cardiomyopathy.
Symptoms Of Cardiomyopathy
Since cardiomyopathy affects the pumping functions of the heart, it can give rise to the following symptoms:
- Abnormal heart rhythms (arrhythmia)
- Chest pain
- Dizziness and fainting
- Low exercise tolerance
- Hypertension (high blood pressure)
- Swelling of the extremities especially the feet and legs
- Fluid accumulation in the abdomen
- Persistent coughing, especially while lying down
Treatment Of Cardiomyopathy
Prior to initiation of treatment, an accurate diagnosis of cardiomyopathy is required. Diagnosis of cardiomyopathy involves a thorough physical exam, electrocardiography (ECG), blood test, genetic testing, and echocardiography.
Treatment of cardiomyopathy can include the following approaches:
Lifestyle changes such as a low salt diet, not smoking, maintaining a healthy weight, and limiting alcohol intake.
Medications to treat high blood pressure, swelling and fluid retention, chest pain, abnormal heart rhythms, and medications to manage heart failure.
Surgical procedures to remove the thickened heart muscle
Implantation of a pacemaker
Heart transplant (in severe cases)
Implantation of an internal defibrillator
Who Is At Risk For Cardiomyopathy?
Family history and genetic factors are one of the biggest predators for development of cardiomyopathy. Other factors that put a person at risk for cardiomyopathy are:
- Severe obesity
- Alcohol dependence
- Chronic hypertension
- Heart attack
Cardiomyopathy can be life-threatening but it often goes undiagnosed. Being aware of your family history regarding cardiac conditions as well as regular heart check-ups can help to detect this condition and initiate treatment if needed.