Dr Swapnil Mate Cardiologist

Types Of Cardiomyopathy

There are five types of cardiomyopathy :-

This type of cardiomyopathy is an inherited cause. Hypertrophic cardiomyopathy is a genetic disorder where the mother, having that mutation in the genes, passes the same genes to her offspring. Another cause of this disorder is Fabry Disease, which is a genetic disorder caused due to the absence of an enzyme called alpha-galactosidase A. This leads to substances build-up in the walls of the coronary arteries and also affects the kidneys and skin. Another genetic disorder that contributes to hypertrophic cardiomyopathy is Friedreich's Ataxia, where there is a mutation in the gene that makes a protein called frataxin. This disease causes loss of sensation in arms and legs and difficulty in a speech that worsens over time. Symptoms of hypertrophic cardiomyopathy include fatigue, swelling of legs, shortness of breath, chest pain, etc.

A type of cardiomyopathy where the heart enlarges and is not able to pump blood properly. It mainly includes enlargement of the ventricular cardiac muscle. Its main causes are the use of cocaine, consumption of alcohol, the influence of genetics, complications during pregnancy, and infections. Symptoms include swelling of legs, chest pain, fluid build-up in lungs, etc.

It is the least common type of cardiomyopathy among the five, where the heart walls are rigid. This does not allow the walls to contract and relax, restricting blood flow. Symptoms include less tolerance to exercises, irregular heartbeat, fatigue, swelling of legs.

It is a type of cardiomyopathy, where the cardiac muscle does not function properly due to genetic defects in it. It primarily affects the tissues of the right ventricle, with associated irregular heartbeats. It first attacks the right ventricle, which puts a lot of stress on the left ventricle, and then, if not treated, stiffens and weakens both the ventricles. Symptoms include irregular heartbeats, blackouts, heart palpitations, etc.

Also known as broken heart syndrome, the main component that causes this syndrome is stress. This causes temporary weakening of the cardiac muscle. Excess amount of adrenaline due to stress or secretion of these chemicals by a tumor, tightens the arteries, raising blood pressure and making the heart work harder, which therefore results in contraction of the coronary arteries that supply blood to the heart. Takotsubo, in Japanese, means octopus trap, and this is called so because the left ventricle takes the shape of an octopus trap.

Signs And Symptoms

The signs and symptoms of cardiomyopathy are :-

Fatigue, due to less oxygen in the body
Swelling of legs due to fluid build-up in the body tissues
Shortness of breath due to lack of oxygen in the lungs
Arrhythmia or irregular heartbeat due to a defect in the electrical conduction system of the heart.
Coughing, while lying down.
Swelling of the abdomen due to fluid build-up in the tissues.
Chest pain

Causes

The main causes of cardiomyopathy are :

Stress - Stress is the primary cause of the occurrence of Takotsubo syndrome. A person can react to stress in ways that can contribute to cardiomyopathy, for example, smoking, alcohol consumption. Overeating, etc.
Obesity -Obese individuals require more blood so that they can carry oxygen and nutrients to the tissues to function efficiently. This puts pressure on the heart to work harder, which stiffens the heart muscle, reducing blood flow and causing this condition.
Diabetes -When your body does not respond to insulin or does not produce much insulin, glucose remains in the bloodstream. This causes an increase in the blood sugar level. An increase in blood sugar damages the walls of coronary arteries due to fatty deposits in the walls. This reduces blood flow to the heart and causes stiffening of the cardiac muscle.
Lack of essential nutrients in the individual's diet like fruits, vegetables, etc.
Iron or calcium build-up in the walls of the coronary arteries.
Connective tissue diseases like Rheumatoid Arthritis, Scleroderma, Churg-Strauss Syndrome.
Valvular disorders like mitral regurgitation, aortic stenosis, tricuspid regurgitation.
Genetic disorders like Hypertrophic cardiomyopathy
Untreated celiac diseases that affect the small intestine may also cause cardiomyopathy.

Further Complications

If the cardiomyopathy is not treated, it can cause further complications, which includes :

Heart attack - a heart attack is caused due to death of the heart muscle. If precautions are not taken to cure cardiomyopathy, it can cause the death of the tissues of the cardiac muscle.
Heart Failure - If the cardiomyopathy is not cured in time, heart muscle stops functioning, which can lead to heart failure.
Blood clots in the affected area - when the plague deposits harden and crack, platelets arrive at the affected area that can cause a blood clot in the coronary arteries. This obstructs the blood flow, leading to possible heart failure.
Sudden cardiac death - for athletes who have cardiomyopathy, if neglected, can even lead to sudden cardiac death

Diagnosis

The diagnostic procedures of cardiomyopathy are :-

Electrocardiography - electrocardiography measures the electrical activity of the heart by placing electrodes on the skin. This detects the minute changes that take place as a result of the contraction and relaxation of the cardiac muscle. This helps to check the electrical activity of the heart and arrhythmia.
Echocardiogram - In this procedure, a device called a transducer is placed on the top of the chest and ultrasonic waves are sent to the heart bounce off and show the live image of the heart, using a monitor. Intravascular ultrasound uses a catheter instead of a transducer to capture the images of coronary arteries. This helps the specialists to see whether the blood flow is obstructed or not.
Blood Tests - blood tests like Low-Density Lipoprotein and High-Density Lipoprotein test, C-Reactive Protein test, International Normalized Ratio(INR) test, Blood pressure test, etc, are done to check the amount of glucose, cholesterol, sodium, and calcium deposits in the bloodstream.
Cardiac Stress test - this test is done by an exercise physiologist who checks the heart's response to vigorous exercises by monitoring the heart's electrical activity.
Genetic testing - this is done when the disorder is inherited from the parent. This is done only on first degree relatives, like father, mother, siblings, etc,

Treatments

Treatments done for cardiomyopathy are :-

Medications - The medications include SGLT2 inhibitors or gliflozins which reduce blood glucose levels without activating the release of insulin from the pancreas. Beta-blockers reduce blood pressure in cardiac patients. Medications like SGLT2 inhibitors and GLP-1 help reduce obesity, hypertension, and blood sugar levels since these three factors contribute to heart diseases. PCSK9 inhibitors are given to reduce cholesterol levels or low-density lipoprotein in the patient's circulatory system. Anticoagulants like warfarin are given to prevent blood from clotting.
Therapies and surgeries - Therapies like alcohol septal ablation procedures involve injecting alcohol(ethanol) into the part where the heart muscle has thickened. It kills the cells of the muscle and shrinks the diseased tissue and restores blood flow to the heart muscle. Surgeries like implanting a ventricular assist device are used to pump blood in the body when the patient has gone through myocardial infarction or if the patient is suffering through heart failure.
Artificial Pacemaker - this device generates electric impulses by the electrodes present in the device that makes the lower and upper heart chambers contract to pump blood. This device regulates the normal function of the electrical system of the heart. Its main purpose is to restore the normal rate of the heart which was either very slow or very fast earlier due to a defect in the natural pacemaker of the heart.
Valve Transplantation - In case the valve is not functioning properly, it is replaced by surgical aortic valve replacement or transcatheter aortic valve replacement is a process conducted very nominally to replace a firm aortic valve that cannot open. It has to be replaced because if the aortic valve cannot open, it diminishes the blood flow from the heart to the body. This procedure is required to prevent aortic stenosis which causes risky symptoms like chest pain, breathlessness, etc.

The cardiology team of Dr. Swapnil Mate's Cardiology clinic includes experienced cardiologists, cardiac surgeons, cardiac imaging specialists who help detect the problem and recommend the ideal surgery to the patients. They mention the advantages and risks associated with the surgeries they plan to do on their cardiac patients. Consult Dr. Swapnil Mate for the best medical assistance.

What Does The Term 'Cardiomyopathy' Mean?