Cardiomyopathy

Diagnosis

If your doctor suspects that you have cardiomyopathy, they will likely perform a physical examination and ask about your personal and family medical history. You may also be asked about the timing of your symptoms, such as whether they worsen during exercise. To confirm the diagnosis of cardiomyopathy, your doctor may conduct several tests, including:

• Chest X-ray. The size of the heart will be shown in an image.
• Echocardiogram. In this test, sound waves are used to produce images of the heart that display its size and beating patterns. This examination of the heart valves aids in identifying the origin of symptoms.
• Electrocardiogram (ECG). Electrode patches are applied to the skin during this non-invasive examination to assess electrical cardiac signals. The electrical activity of the heart can be disturbed by an ECG, which can reveal areas of damage and abnormal cardiac rhythms.
• Treadmill stress test. While walking on a treadmill, blood pressure, respiration, and heart rate are observed. This test can assess symptoms, establish exercise capacity, and reveal whether strenuous activity causes irregular heartbeats.
• Cardiac catheterization. A tiny tube (catheter) is placed into a blood artery in the groin and guided to the heart. How forcefully blood pumps through the heart can be determined by measuring the pressure within the heart’s chambers. When performing a coronary angiography, blood arteries can be dyed to make them more visible on X-rays. A cardiac catheterization might show blood vessel obstructions.

A tiny tissue sample from the heart may also need to be removed (biopsy) for this test in order to be analyzed in a lab.

• Cardiac Magnetic Resonance Imaging (MRI). Radio waves and magnetic fields are used in this procedure to produce images of the heart. If the echocardiography pictures are insufficient for a diagnosis, a doctor may request a cardiac MRI.
• Cardiac Computed Tomography (CT) scan. This entails reclining on a table inside a machine. To evaluate the size, function, and condition of the heart and its valves, an X-ray tube inside the machine spins around the body and gathers images of the chest and heart.
• Blood tests. Blood tests may be performed for several purposes, such as determining iron levels and evaluating kidney, thyroid, and liver function.

B-type natriuretic peptide (BNP), a protein made in the heart, can be measured by a single blood test. When a person experiences heart failure, a typical cardiomyopathy consequence, their blood level of BNP may increase.

• Genetic testing or screening. Cardiomyopathy can be inherited and handed down through families. If you want to know if genetic testing is right for you, go to your doctor. Parents, siblings, and children are first-degree relatives who may be subjected to genetic testing or family screening.

Treatment

The goals of cardiomyopathy treatment are to:

• Control symptoms and signs
• Stop the condition from getting worse.
• Lower the possibility of complications

The treatment approach for cardiomyopathy depends on the type and severity of the condition.

Medications

Medications are a common treatment option for cardiomyopathy. These medications may work by:

• Boost blood pumping capacity of the heart and blood flow
• Decrease blood pressure
• Decrease heart rate
• Get rid of excess body fluid
• Avoid clotting of blood

Therapies

The following nonsurgical techniques are used to treat cardiomyopathy or arrhythmia:

• Septal ablation. In alcohol septal ablation, a catheter (a long, thin tube) is used to inject alcohol into the artery that supplies blood to the thickened heart muscle. This causes a small portion of the muscle to be destroyed, allowing blood to flow more freely in the area.
• Radiofrequency ablation. Medical professionals can use long, flexible tubes (catheters) to treat irregular heartbeats by inserting them into the heart’s blood vessels. The catheter’s tip is equipped with electrodes that can be used to target and damage a small area of cardiac tissue that is responsible for the abnormal heart rhythm.

Surgery or other procedures

To improve the heart’s function and relieve symptoms, several devices can be surgically implanted in the heart, including:

• Implantable Cardioverter-Defibrillator (ICD). An ICD does not treat cardiomyopathy; rather, it watches for and regulates irregular rhythms, a significant complication of the illness. This device monitors heart rhythm and delivers electric shocks when necessary to control irregular heart rhythms.
• Ventricular Assist Device (VAD). A VAD, which can be used as a long-term treatment or as a short-term treatment while awaiting a heart transplant, is typically considered after less invasive approaches are unsuccessful.
• Pacemaker. To manage arrhythmias, a tiny device is inserted under the skin in the chest or belly.

The following surgical procedures are used to treat cardiomyopathy:

• Septal myectomy. A portion of the wall of the thicker heart muscle that separates the two bottom heart chambers is removed during this open-heart procedure. The blood flow through the heart is improved, and mitral valve regurgitation is decreased, when a portion of the heart muscle is removed. Treatment for hypertrophic cardiomyopathy involves septal myectomy.
• Heart transplant. Individuals with end-stage heart failure, for whom conventional treatments have proven ineffective, may require a heart transplant as a last resort.