Cardiomyopathy is a group of heart diseases with four main types: hypertrophic, restrictive, dilated, and arrhythmogenic right ventricular dysplasia. Causes include genetics, alcohol/drug abuse, infections, high blood pressure, and pregnancy. Treatment options include medication, surgery, and implanted devices.
The term cardiomyopathy refers to a number of diseases that affect the heart. There are four main types of cardiomyopathy: hypertrophic cardiomyopathy, restrictive cardiomyopathy, dilated cardiomyopathy, and arrhythmogenic right ventricular dysplasia, or ARVD. Cardiomyopathy can have several causes. It can be genetic or it can occur due to alcohol and drug abuse, infection with various diseases, high blood pressure, nutritional deficiency, and even pregnancy. Sometimes, however, cardiomyopathy occurs without a recognizable cause, in which case it is known as idiopathic cardiomyopathy.
Idiopathic dilated cardiomyopathy, considered the most common type of cardiomyopathy, occurs when the heart muscle stretches and thins without any recognizable cause. The thinning and lengthening of the heart muscle means that the chambers of the heart get bigger. Over time, the heart muscle begins to lose its ability to pump blood efficiently. Symptoms may include swelling or fluid retention in the ankles, legs, feet, and abdomen; difficult breathing; and tiredness. Ultimately, dilated cardiomyopathy can lead to heart failure.
Hypertrophic cardiomyopathy is also prevalent and is termed idiopathic when the cause cannot be determined. In hypertrophic cardiomyopathy, the walls of the ventricle and sometimes the mitral valve walls of the heart thicken. Eventually, ventricle blockage can occur, which places undue stress on the heart muscle as it struggles to pump blood through the narrowed ventricular passages. Hypertrophic cardiomyopathy doesn’t always lead to blockage of the ventricle, but even if it doesn’t, the heart loses efficiency. Symptoms of hypertrophic cardiomyopathy can include dizziness, difficulty breathing, chest pain, arrhythmia, fainting, and exercise intolerance.
ARVD is perhaps the rarest form of idiopathic cardiomyopathy. It is typically found in young adults and adolescents. In ARVD, necrosis affects the right ventricular muscle and scar tissue grows in place of previously healthy heart muscle tissue. Symptoms can include arrhythmia, fainting, exercise intolerance and even sudden cardiac arrest.
Idiopathic restrictive cardiomyopathy is similar to ARVD in that it too causes scar tissue to develop instead of healthy heart tissue. This type of cardiomyopathy most often affects the elderly. Scar tissue in the heart is stiffer than healthy muscle tissue, and its presence means the heart can’t pump properly. Symptoms include arrhythmia and heart failure.
Idiopathic cardiomyopathy can be treated with medications to lower blood pressure, reduce arrhythmias, prevent blood clots, and slow the heart rate. Open heart surgery can be performed to correct heart muscle deformities. A heart transplant may be needed if the damage to the heart muscle is severe. Surgically implanted devices can help improve heart function and control arrhythmia. A procedure known as alcoholic septal ablation can treat thickened ventricles without invasive surgery.
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