Changing Lifestyles, Changing Habits: Living with Cardiomyopathy
Cardiomyopathy is a fairly rare heart condition, but it's a serious one.
You may know it as "enlarged heart," which is how some people
refer to it. Normally, the heart is just the right size, with
just the right degree of flexibility in its tissue, to pump
blood effectively throughout the body. In cases of cardiomyopathy,
the heart muscle becomes inflamed and doesn't pump blood as
well as it should.
affects about 50,000 Americans, a relatively small number.
But it's the leading reason for most heart transplants.
takes three forms:
This form is almost always inherited, and it's the most
rare of the three. Hypertrophic cardiomyopathy causes an
abnormality in the growth and arrangement of the heart muscles.
The heart walls become thickened, especially in the left
ventricle. The blood flow and pumping ability of the heart
are limited. Treatment can consist of lifestyle changes,
such as reducing activity level; medication; pacemaker implantation
This type of cardiomyopathy is rare in the U.S. It's typically
caused when another illness, not related to the heart, eventually
causes the walls of the heart's ventricles to stiffen. The
heart loses its ability to pump blood effectively.
We'll provide more details on this type of cardiomyopathy,
since it's the most common form. It occurs most frequently
in middle-aged people, and in more men than women. But the
condition can affect people of all ages, even children.
Dilated cardiomyopathy causes one or more chambers of the
heart to become enlarged and stretched. Diseased heart muscle
fibers cause this stretching and enlargement. The ability
to pump blood effectively decreases, and the heart tries
to make up for this pumping problem by enlarging even further.
are the Causes?
cases, the cause of dilated cardiomyopathy is never determined.
But there are some known causes:
alcohol use (especially harmful when combined with a poor
infections, which can lead to inflammation of the heart
(this is a rare cause)
itself often causes no symptoms at first, but the condition
eventually causes the heart to become weaker and weaker. Heart
failure is often the result. Symptoms of heart failure include:
of breath (this can be severe, and is sometimes accompanied
by a cough)
of the hands and feet due to fluid accumulation, which may
also affect the lungs
dilated cardiomyopathy is in the advanced stages, there may
be pain in the chest or abdomen. Some patients may develop
irregular heartbeats, which can be life-threatening.
cardiomyopathy is typically diagnosed by performing the following
to show whether the heart is enlarged
which detects abnormal electrical activity in the heart
which uses sound waves to produce pictures of the heart
cases, doctors treat dilated cardiomyopathy in a combination
they eliminate any known causes, such as alcohol consumption.
Patients also get information about foods to eat and foods
to avoid. Often, salt is strictly limited.
are often used as well. There are drugs that can help remove
excess fluid, help the heart's pumping ability and regulate
pumping device, called a ventricular assist device (VAD),
can be implanted. Initially, doctors used VADs to keep patients
alive until a transplantable heart became available. But
recent news has shown that VADs may be possible for long-term
treatment of heart failure, and that they may be more effective
than medication. (See the news
article in this issue of the magazine for more information
about the VAD.)
transplants may become the best alternative if the patient
isn't responding to other treatment.
Lifestyle and Regular Doctor Visits Important
that dilated cardiomyopathy takes can vary from person to
person. Some people may not respond well to treatment, while
others do extremely well for many years.
been diagnosed with cardiomyopathy, or with heart failure,
which often results, be sure to maintain regular visits with
your doctor and the other members of your healthcare team.
You may also want to consider joining a support group for
people with heart failure. Getting advice and feedback about
making dietary changes, getting the right amount of exercise,
managing stress and taking medication regularly can be invaluable.
The American Heart Association; The National Heart, Lung,
and Blood Institute; M. Silver. Success with Heart Failure.
Insight Books/Plenum Publishing, New York, New York, 10013,