Cardiomyopathy involves a weakening of the heart muscles or structural changes in these muscles. This often leads to inadequate heart pumping or problems with the functioning of the heart.
The poor heart pumping mechanism leads to accumulation of fluid in the lungs, liver, and other body systems. Cardiomyopathy is classified into three morphologic types: dilated, restrictive, and hypertrophic. When the exact cause is not known the term used is idiopathic.
- Hypertrophic Cardiomyopathy: In this condition the heart muscles get thicker making it harder for blood to leave.
- Dilated Cardiomyopathy: Weakening and enlargement of the heart muscles prevent it from pumping blood efficiently.
- Restrictive Cardiomyopathy: This condition is associated with increased stiffness of the heart.
Symptoms include palpitation. difficulty with breathing (dyspnoea) and sometimes even Sudden death can occur, Complications like pulmonary oedema, arrhythmias and ascites can occur.
Sudden cardiac death is the most dreaded of the complications. International guidelines recommend that a risk stratification score can predict the outcome. These are the six risk factors to look for in a patient with Cardiomyopathy:
- Previous cardiac arrest or sustained ventricular tachycardia,
- Non-sustained ventricular tachycardia,
- Extreme left ventricular hypertrophy,
- Unexplained syncope,
- Abnormal blood pressure response,
- Family history of sudden death
Diagnosis is generally established by chest X-ray and two-dimensional echocardiography. In case the echocardiogram is of poor quality then the alternatives Gadolinium cardiovascular magnetic resonance magnetic resonance imaging (MRI) and computed tomography (CT).
Treatment and outlook of Cardiomyopathy depends on a number of factors like cause & type of Cardiomyopathy. Heart transplant is a treatment option for selected patients with hypertrophic Cardiomyopathy (HCM).
- Cecil Medicine, 23rd Ed.
- Harrison's PRINCIPLES OF INTERNAL MEDICINE, 17TH Edition
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