When part of the heart is damaged—by a viral infection or as a result of coronary artery disease, high blood pressure, heart attack or alcohol abuse, for example—the healthy part compensates by stretching and enlarging. This extra and rather amazing effort works for a little while, but over time the heart’s pumping action gets weaker and weaker. The result is dilated cardiomyopathy, a serious disease of the heart muscle that sets the stage for heart failure.
Although dilated cardiomyopathy is the most common form, cardiomyopathy—literally “heart muscle disease”—takes other forms, too. In hypertrophic cardiomyopathy, the heart walls are thicker than normal, often preventing adequate blood flow through the organ. And thickening of the septum (the wall between the left and right ventricles) frequently causes a leak in the mitral valve. Most commonly seen in young adults, hypertrophic cardiomyopathy runs in families and may cause sudden cardiac death.
A rare, third type of heart muscle disease, called restrictive cardiomyopathy, occurs when the whole heart muscle becomes rigid. The heart loses its ability to expand and contract properly and fails to fill with enough blood between beats. The less blood that enters the heart, of course, the less blood that can be circulated through the body.
Symptoms of cardiomyopathy include shortness of breath, fatigue, palpitations, weakness, chest pain, dizziness, fainting and swelling. Unfortunately, by the time symptoms appear, cardiomyopathy is often well advanced. If the disease is triggered by another condition, such as high blood pressure, alcohol abuse or hemochromatosis (a disorder in which the body absorbs too much iron), treating the underlying problem may help ease it.
Although cardiomyopathy is a very serious diagnosis, current treatment methods are greatly improving patients’ outlook. Medications, for one, can effectively control symptoms and help prolong life: Beta blockers and calcium channel blockers can relax the heart’s contractions, diuretics rid the body of excess fluids, anti-arrhytmics control abnormal heartbeats and vasodilators enhance blood flow by widening vessels.
On the surgical front, doctors are experimenting with laser and other procedures, and heart transplantation may also be an option. Left ventricular assist can help patients with cardiomyopathy remain comfortable, if not active, until a donor heart becomes available.
Because no two cases of cardiomyopathy are alike, patients benefit greatly from a customized treatment program. Following doctors’ instructions and having a strong support network also can help a person with cardiomyopathy feel his or her best.