Cardiomyopathy may be:
- primary – when the cause is either unknown or impossible to influence (for example, a gene defect);
- secondary when the cause can be found.
Primary cardiomyopathy has its own classification, where each subspecies differs for its reason, main symptoms and treatment approaches. So, it happens:
- arrhythmogenic right ventricular.
The classification of secondary pathology is based on the cause of the disease. So, cardiomyopathy happens:
- dishormonal (including thyrotoxic, diabetic and menopausal);
- toxic (including alcohol);
Cardiomyopathies are a large group of myocardial diseases, implying such changes in the heart muscle that inevitably lead to:
- heart enlargement
- heart failure
- myocardial dystrophy.
The causes of this pathology are a great many, in fact, as well as forms of cardiomyopathies. Consider the main options and classification of cardiomyopathies, as well as touch on the causes of this or that form of the disease.
- Dilated cardiomyopathy. This is a myocardial disease in which there is expansion, distension and an increase in the size of the heart chambers. The disease develops due to genetic disorders, attacks of viral agents, immune pathology, and the cause of many cases of the disease remains unclear.
The classification of the disease is very impressive and extensive, it already laid down the main causes of the development of the disease, because the disease does not occur from scratch. She is always preceded by genetic, intracellular disorders. But even in our century of modern medicine, doctors are not always able to accurately determine the cause of cardiomyopathy. In the classification for such cases, a heading is provided, called “unclassified cardiomyopathy.”
What are the main symptoms of cardiomyopathy? How can you suspect a disease? All forms of the disease have similar symptoms, such as:
- Heart rhythm disturbance
- Swelling of the legs
- Weakness, fatigue.
Each form of cardiomyopathy has its own characteristic features.
In order to understand the essence of this disease, you should start by analyzing the term itself:
- “Cardio” (cardio) in Greek means the heart.
- “Mio” is all that is associated with the muscle layer.
- “Patia” (pathos) – suffering.
Thus, the analysis of the indicated term practically does not clarify the overall picture. Any heart disease provokes painful sensations in the patient.
- Idiopathic or primary cardiomyopathy. What exactly causes cardiac pathology is still not known in this case.
- Secondary. The alleged causes of the development of this cardiomyopathy are:
- Hereditary predisposition. A person can inherit a genetic abnormality that causes errors in the structure and functions of muscle fibers. The outcome of the disease with hereditary cardiomyopathy is impossible to predict.
- Viruses. Pathogens of influenza, herpes, etc. are included in this group.
- The presence of a history of information about previous myocarditis.
- Failures in the functioning of the endocrine system. This concerns the harmful effects of catecholamines and somatropic hormone on the anatomical structures of the heart muscle.
- The inability of the body’s defenses to fully perform their work.
- A harmful effect on the heart muscle of a variety of toxins and allergens. Irritants can include heavy metals, some medical supplies, alcohol, and drugs.
In extremely rare cases, the disease in question is diagnosed in the last months of pregnancy, or in the first half of the postpartum period.
Specialists in the field of medicine distinguish several types of cardiomyopathy:
Each of the listed forms is characterized by a characteristic effect in relation to the heart, but the scheme of their treatment is the same. The main goal of therapy is to eliminate the causes that caused myocardiopathy, as well as cope with heart failure.
The hypertrophic form is characterized by a thickening of the wall of the right or left ventricle. Dilation is accompanied by an increase in heart chambers and systolic dysfunction. In this case, the wall thickness remains unchanged.
A restrictive type of disease is rarely diagnosed. In the presence of this condition, a rigid structure of the walls of the heart is noted. In addition, his ability to achieve a relaxation phase is reduced. This entails a deterioration in blood flow, against the background of which the left ventricle lacks oxygen. The work of the whole organism suffers from this, since blood circulation is disturbed.
- 2 Symptoms of dilated cardiomyopathy
- Cardiopathy of the heart: symptoms, diagnosis and treatment
- 3 Symptoms of hypertrophic form
- The dangers of cardiomyopathy
- Myocardial infarction
- Pulmonary edema
- 4 Symptoms of restrictive cardiomyopathy
- Pathology specificity
- Types of Cardiomyopathy
- Types of cardiomyopathy and the causes of the disease – who is at risk?
- Complications of Cardiomyopathies
2 Symptoms of dilated cardiomyopathy
It should be noted that patients with this diagnosis in 90% of cases are men aged 40-45. The onset of the disease is subtle. Patients note shortness of breath, but attribute it to increased physical activity, a consequence of hard work. But after several months/years, shortness of breath progresses, and is already more worried. Upon medical examination, an X-ray of the OGK, an increase in the heart is detected – cardiomegaly.
Cardiopathy of the heart: symptoms, diagnosis and treatment
Since each type of disease has its own mechanism of development and progression, the symptoms of cardiomyopathy will differ.
If a person has an obstructive form of this disease (that is, the diameter of the hole from which the aorta originates is reduced), signs of insufficient blood supply to the brain develop:
- bouts of dizziness;
- shortness of breath
If an obstructive form occurs, cardiomyopathy may persist asymptomatically for a long time. Then it can develop and progress pretty quickly:
- shortness of breath, which at first accompanies only physical activity, but then appears at rest;
- edema – initially only on the legs, then higher;
- heaviness in the right hypochondrium;
Violation of the rhythm with this pathology is not always felt subjectively, but they are dangerous. Among male athletes, there are times when fibrillation developed suddenly and caused sudden death.
Cardiopathy is a group of non-inflammatory diseases of the heart muscle caused by cellular metabolism. This pathology of the heart is found in both adults and children.
This is due to the rhythmic contraction (pushing blood into the vessels) of cardiomyocytes – the cells of the heart muscle responsible for metabolic processes. Impaired functioning of the heart muscle leads to a pathology called cardiopathy, which leads to many complications, and in the case of an advanced stage, to death.
Since cardiopathy is a collective designation of myocardial lesions, each type of disease has its own causes. Let’s consider them in more detail.
Cardiopathy develops under the influence of factors causing metabolic disorders in cardiomyocytes.
The main causes of heart muscle disease are:
- Hereditary factors. Cardiac muscle cells are made up of proteins actively involved in myocardial function. Congenital pathology of one protein leads to disturbances in the activity of the entire heart muscle. The cause of the violation is difficult to identify. Cardiopathy develops independently, that is, it is the primary lesion.
- Viruses. Viruses present in the body disrupt the activity of the DNA chain and cause the development of pathology of the heart muscle cells.
- Autoimmune abnormalities. Various pathological processes trigger autoimmune mechanisms that are difficult to stop. Pathology is rapidly developing and taking an unfavorable course.
- Primary fibrosis of the heart. Fibrosis (cardiosclerosis) is the process of replacing muscle tissue with connective tissue. Cardiomyocytes lose their elasticity and ability to contract.
The causes of cardiopathy are poorly understood and have an unclear etiology, therefore, most often the disease is diagnosed by pronounced symptoms, without finding out the true cause of the pathology. Hypertension, ischemia, endocrine diseases, poisoning, neuromuscular diseases can provoke cardiomyopathy.
Cardiopathy, the symptoms of which are mild and do not bother the patient, can occur at any age. The diagnosis of cardiopathy is complicated by the fact that the symptoms that accompany it are common, they can easily be confused with other diseases caused by insufficient heart function and characteristic of other cardiopathologies.
In patients who have cardiopathy, the symptoms are diagnosed the same, they include:
- Shortness of breath is a respiratory failure resulting from stagnation of blood. It is accompanied by asthma attacks, manifested against the background of stressful situations, excessive load.
- Coughing. The reasons are the same as with shortness of breath. With a complication accompanied by pulmonary edema, wheezing and sputum appear, which indicates an accumulation of fluid in the lungs.
- Cardiopalmus . An increase in heart volume leads to a disturbance in the rhythm of heart contractions, which increase heart rate.
- Pale skin and acrocynosis. Failure to receive enough blood to the tissues is manifested by pallor of the skin and blueness of the tips of the fingers and nose.
- Swelling of the lower extremities. Blood stagnates, its output provokes edema.
- Sternal pain caused by hypoxia of the heart muscle.
- Enlarged liver and spleen. The accumulation of blood in the portal vein leads to an increase in organs.
- Dizziness and fainting arise from a lack of oxygen in the tissues of the brain.
- Excessive fatigue is associated with insufficient oxygen supply to the muscles.
Additional instrumental studies will help to accurately diagnose the disease: electrocardiography (ECG), echocardiography (EchoCG), radiography.
According to the results of a medical examination, a cardiologist will determine the type of cardiomyopathy and prescribe treatment.
Specialists classify cardiomyopathic forms depending on the severity of their clinical picture. There are several types of cardiopathy.
Dyshormonal. It manifests itself due to a lack of sex hormones, has a non-inflammatory character. More likely to be women in menopause.
Infectious toxic cardiopathy (alcoholic). Toxins affect muscle tissue, as a result, pathology develops, destroys and affects heart cells.
Dysmetabolic cardiopathy. It is caused by metabolic disorders, often develops against the background of diabetes mellitus and thyroid dysfunction. Not associated with inflammation.
Dysplastic. Congenital intrauterine pathology. As a result of pathological expansion of the heart valves, malformations develop, resulting in blood clots. May result in sudden death.
Functional. It depends on the functional activity of the autonomic system that regulates the vital activity of all systems and organs of a person. It appears more often in the puberty.
Posthypoxic or metabolic cardiopathy occurs against the background of ischemia. Lack of oxygen leads to irreversible changes in metabolism.
Ischemic is associated with posthypoxic, accompanied by narrowing of the lumen of the coronary arteries.
Tonsillogenous is the result of autoimmune inflammation. Immunodeficiency upsets the metabolism.
There is also primary and secondary cardiopathy. The primary form is a congenital pathological metabolic disorder, diagnosed in newborn children. Secondary cardiopathy develops in adults due to etiology.
Functional cardiopathy in children is a small abnormality in the development of the heart. Sources of most psychological and physiological disorders are hidden in early childhood. Accumulating happy memories of this period, people simultaneously acquire various pathologies.
Often they arise under the influence of certain factors at a young age and in adolescence under the pressure of disharmony of the hormonal background. The disease may be congenital or acquired.
Both varieties equally negatively affect the development of the heart muscle, leading to the following disorders:
- disproportionate structure of the ventricle;
- the formation of additional chords;
- development of valvular defects, including mitral valve prolapse;
- thickening of the interventricular septum, etc.
There are 3 groups of sources of cardiopathy in children and adolescents:
- myocardial disorders that occurred during the period in the womb;
- consequences of other pathologies;
- functional disorders of myocardial development.
- A congenital form of pathology can manifest itself from the first days of life, but most often these signs occur during the period of primary school age.
- For this reason, cardiopathy is difficult to diagnose in babies who cannot clearly explain their feelings.
- During this period, it is difficult to hear characteristic heart murmurs, and therefore the task of parents is to monitor the child during physically active games in order to timely identify symptoms of the disease.
- In adolescence, cardiopathy manifests itself in symptoms of increased fatigue, in the form of increased heart rate and the occurrence of extraordinary contractions of the myocardium (extrasystoles).
- If a child detects myocardial disorders, the specialist’s task is to explain to parents the full picture of the disease.
- In this case, the child has a small anomaly in the development of the heart, which, if the physical loads are not correctly distributed, can lead to a malfunction in the heart rhythm.
- Ignoring this fact and further encouraging parents to do dancing, gymnastics or attending physical education lessons negatively affects the work of the child’s injured organ.
- Excessive exercise can trigger symptoms of heart failure.
- Functional cardiopathy in children is most often manifested in elementary schoolchildren and adolescents, and is expressed by the following signs characteristic of autonomic dysfunction:
- pallor of the skin;
- heart rhythm disturbances;
- shortness of breath;
- increased sweating;
- in some cases, fainting.
Cardiopathy of the heart should be detected on time to begin timely treatment. To collect preliminary data on the patient’s condition, the doctor examines and talks with the patient.
The following studies contribute to obtaining in-depth information about cardiopathy and methods of its treatment:
- ECG, based on which you can track changes in the ventricles, heart rhythm disturbances.
- An X-ray of the lungs that reveals a fluid in an organ or a change in its size. These, as well as other similar disorders, may indicate infectious toxic sources of the disease.
- Ventriculography is an invasive technique for examining a patient’s condition.
- MRI – a study of the state of the myocardium by radio waves.
- MSCT – a layered examination of heart tissue, a laboratory study of its integument.
The doctor can alleviate the patient’s condition with valerian tablets, prescribe the use of beta-blockers in a strictly specified dosage, and undergo an interference therapy procedure for children over 10 years of age.
Therapy of cardiopathy in adult patients includes their use of a complex of drugs that affect the sources of pathology: diabetes mellitus, menopause, infection, poisoning. At the same time, the doctor prescribes the patient the use of drugs that stop the manifestations of the disease.
Such preparations are:
- ACE inhibitors;
- beta blockers;
- substances that prevent calcium from entering the blood;
- homeopathic remedies;
With the development of dysmetabolic forms of cardiopathy, the patient is prescribed therapy with drugs that normalize metabolic processes in the myocardium. Observation of a dilated form of the disease in a patient involves the use of antihypoxants, antioxidants and vitamins.
Pain in the region of the heart
3 Symptoms of hypertrophic form
A dizzy can occur both sporadically, without causing particular discomfort, or for a long time, expressed, up to several days. Fainting can be complicated by convulsive syndrome. Pain in the heart does not have any special specific clinic, they are similar to angina pectoris, but can also correspond to cardialgia (have a stabbing, short-term nature, without regard to physical activity). There is evidence that with this diagnosis, pain is more characteristic of women. A frequent symptom is a heartbeat, irregular heartbeat rhythm.
The dangers of cardiomyopathy
As we see, all types of this pathology lead to the development of heart failure. Most often, it has a chronic stagnant nature, associated with a decrease in the volume of blood released into the vessels, as well as oxygen starvation of the internal organs.
In some cases, acute heart failure may develop:
- systolic – when the heart cannot contract normally and push out enough blood. This is characteristic of the dilated form of pathology;
- diastolic: the ventricle is not filled with enough blood. This is characteristic of the restrictive type of cardiomyopathy.
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This is the name of the condition when a larger or smaller portion of the myocardium dies due to insufficient blood supply.
This “pure” complication is characteristic of hypertrophic cardiomyopathy, because such a thickened myocardium is difficult to provide with sufficient oxygen. But a similar pathology can develop with any other form of the disease, if it is combined with the abnormal structure of the coronary arteries that feed the heart, their atherosclerosis, or the development of hypertension.
A heart attack should be suspected if:
- there was a sharp and severe pain behind the sternum;
- she gives to the left hand (the little finger of this hand), the left shoulder, shoulder blade or left half of the jaw;
- pain does not respond to nitroglycerin;
- there may be a single vomiting that does not alleviate the condition;
- the person turns pale;
- covered with cold sweat;
- breathing quickens.
In this case, you need to give 1-2 chewing tablets of “Aspekarda” (“Aspirin”, “Cardio-Magnolia”), lay it down, open the window and call the “Ambulance”.
Blood stasis, characteristic of a heart with an affected myocardium, causes activation of the blood coagulation system. So blood clots appear. Arrhythmias, that is, uneven muscle contractions, in turn, increase the likelihood of a “trip” of such a blood clot from the cavity of the heart (in this case, a blood clot is called a thromboembolum) with their subsequent fixation in a vessel “suitable” in diameter. The organ or part thereof, fed by this vessel, dies.
The most dangerous thromboembolism is:
- ischemic stroke – due to a blockage by a thrombus of one of the arteries of the brain;
- thromboembolism of one or more branches of the pulmonary artery, leading to a deterioration in blood supply to various parts of the lung;
- mesenteric thrombosis – when a thromboembolus clogs a more or less large arterial branch that feeds the intestine, which leads to the death of its various areas;
- thrombosis of arteries of the limbs, resulting in gangrene.
Violation of the normal sequential contraction of myocardial cells leads to oxygen starvation of tissues. If the “scatter” of the ventricle cells begin to contract, and this condition cannot be urgently corrected, a person may die.
When congestion develops in the left half of the heart, an excess volume of blood remains in the vessels that go to the lungs. Over time, these vessels expand and begin to pass the liquid part of the blood through its wall – into the lung tissue.
The condition requires emergency medical attention, and is manifested by shortness of breath, pink foam from the mouth, blue lips and fingertips, a feeling of lack of air and panic.
4 Symptoms of restrictive cardiomyopathy
If the left heart sections are more affected, then the following symptoms prevail: shortness of breath, dry, obsessive cough, heart murmur, possible separation of coughing up blood streaks with sputum, the patient’s condition improves when sitting. It is not uncommon for patients with decompensation of the pathology to go out to pulmonary edema – a deadly complication of left ventricular failure.
For all types of cardiomyopathy, diagnosis is a rather complicated process and can take a long time due to the fact that the clinical picture of different pathologies has similar signs. It can be difficult to establish the primary or secondary pathological changes in the myocardium. In this regard, when verifying the diagnosis, the doctor takes into account the totality of data obtained as a result of a comprehensive examination of the patient. This is the only way to determine the type of disease and prescribe the appropriate treatment. What kind of examination is this?
- Physical methods are the first things that begin with the diagnosis of heart disease. This includes an external examination of the patient, measurement of pulse and blood pressure on the arms and legs, palpation (palpation (detecting edema and other changes in the body), percussion (tapping the borders of the heart, liver), auscultation (listening to wheezing in the lungs, heart tones and noises )
- Electrocardiography (ECG) – recording and assessment of the electrical activity of different parts of the myocardium. For all types of disease, changes in the rhythm of heart contractions of a different nature are observed, most often these are ventricular forms of tachycardia and atrial fibrillation. Signs of left ventricular hypertrophy are of diagnostic value, and the right heart is less likely to enlarge.
- Daily ECG monitoring (Holter examination) – allows you to clarify the type and degree of rhythm disturbances, to catch arrhythmia attacks, the presence of signs of ischemia and other problems.
- Echocardiography (ultrasound of the heart) with dopplerography is the most informative method for the diagnosis of cardiomyopathy, which allows you to visually assess the condition of all parts of the heart, the volume of chambers, the thickness of the walls and walls, blood flow, valve function, and blood clots. The value of the ejection fraction has a diagnostic value in heart failure; in patients with dilated cardiomyopathy, it decreases to 30-35% (with a norm of 50-55%).
- Radiography – is used as an additional way to quickly assess the anatomy of the heart and lungs. The method allows you to determine the size, shape and position of the heart, the degree of its displacement in the chest. In addition, the state of the lung tissue and vascular pattern is assessed (it increases in case of stagnation).
On an individual basis, patients with suspected cardiomyopathy may be prescribed additional diagnostic measures, for example, genetic tests, blood tests for biochemistry, electrolytes, hormones, MRI or CT, coronarography, taking material for a biopsy from myocardium and endocardium.
The most important diagnostic screening method is echocardiography. The main criterion for making a diagnosis is revealed systolic, diastolic or mixed myocardial dysfunction.
During a physical examination noted:
- percussion expansion of the borders of the heart in both directions;
- systolic murmur at the apex and under the xiphoid process;
- tachycardia, atrial fibrillation, extrasystole, gallop rhythm;
- signs of left ventricular failure – peripheral edema, ascites, jugular vein swelling, enlarged liver;
- signs of pulmonary hypertension – an accent of II tone above the pulmonary artery, moist small-bubbling rales in the lower parts of the lungs;
On echocardiography, depending on the type of disease, they detect:
- DKMP – dilatation of the heart cavities, decreased contractility, hypokinesia of the posterior LV wall, decreased PV, MK in the form of a fish pharynx.
- GKMP – asymmetric LV hypertrophy (thickness 15 mm. And more), pre-systolic movement of MK, dynamic pressure gradient in the external tract.
- RKMP – thickening of the posterior basal wall of the left ventricle, restriction of the mobility of the posterior cusp of the MK, thickening of the endocardium, thrombosis in the ventricular cavity.
To clarify the diagnosis and differentiation with other diseases carry out:
- ECG, round-the-clock ECG monitoring – the presence of conduction disturbances, arrhythmias, extrasystoles;
- X-ray diffraction pattern of OGK;
- Cardiac cavity sounding, ventriculography;
- Myocardial biopsy;
- Functional Cardioprobe
- Laboratory examinations – clinical analysis of blood, urine, determination of ALT, AST, creatinine, urea, coagulogram, electrolytes.
Cardiomyopathy, even occurring without pronounced symptoms, can be suspected by:
- X-ray, which will show an increase in heart volume;
- examination data, during which the cardiologist who listened to complaints determines the boundaries of the heart, listens to arrhythmia, muffling or deafness of its tones, some heart murmurs;
- an electrocardiogram, which reveals signs of an increase in certain parts of the heart, clearly allows you to establish the type of arrhythmia.
The diagnosis of cardiomyopathy is made on the basis of the data of those instrumental studies that allow you to visualize the heart. Optimally this is “able” by magnetic resonance imaging, showing each part of the heart in layers. But this method is not so good at measuring the degree of contraction of each chamber of the heart and the volume of blood ejected, like ultrasound of the heart (Echo-echocardioscopy).
Laboratory diagnosis: the presence of antibodies to viruses, an increase in the level of cardiac enzymes, which indicate damage to the structure of heart cells, helps to determine the cause of the disease.
- The diagnosis of dilated cardiomyopathy is made when the cavity of the left ventricle in the diastole expands to 6 or more centimeters in diameter. The myocardium is diffusely affected, there is no hypertrophy, the heart valves are not damaged. In this case, the ejection fraction (on the ultrasound conclusion is written “PV”) is reduced to 45% or less.
On the ECG: extrasystole, various types of blockades, paroxysmal tachycardia, atrial fibrillation.
Measurement of blood pressure: a tendency to decrease it.
On the chest x-ray – the expansion of the borders of the heart.
- Hypertrophic cardiomyopathy is when
EchoCS notes an increase in the thickness of the walls of the heart to 1,5 cm or more, while the volume of the chamber is normal or less. The obstructive form implies an increase in the thickness of the interventricular septum up to 2,5-4 cm, a deterioration in its mobility, prolapse of the cusp of the mitral valve into the systole.
On the ECG, signs of an enlargement of the left ventricle appear.
An X-ray may not show anything for a long time, as the heart expands to the “out”, and the thickness of its wall grows.
- Retreative cardiomyopathy.
On the echocardiography – a decrease in the cavity of the ventricle (mainly the left), a reduced volume of filling the heart cavity with blood, a decrease in the ejection fraction, insufficiency of mitral or tricuspid valves.
ECG shows ventricular arrhythmias, atrial fibrillation, there may be signs of ischemia.
X-rays show signs of stagnation in the lungs, while the heart can be normal or enlarged.
- Arrhythmogenic right ventricular cardiomyopathy.
On the echo: moderate expansion of the right ventricle, impaired mobility of the walls of the heart.
Here, MRI is indicative, which reveals local thinning of the heart wall, its aneurysm – protrusion, which remain unchanged in systole and diastole (more about heart aneurysm).
An ECG shows the type of arrhythmia: blockade, ventricular extrasystole, ventricular tachycardia, ventricular or atrial fibrillation.
X-ray is not indicative.
The presence of cardiomyopathy, the doctor may suspect when examining the patient. As a rule, listening to the heart allows you to detect extraneous noise, tones. To clarify the diagnosis, the patient may be assigned such studies as radiography, ECG, ultrasound, monitoring by the method of Holter, MRI. Using these diagnostic methods, it is possible to detect changes in the departments of the heart, evaluate the contractility of the myocardium, and detect thickening of the walls.
Cardiopathy of the heart is successfully treated with timely access to qualified help, conducting regular examinations of the heart muscle significantly reduces the risk of cardiopathy flowing into a severe stage.
The diet for cardiomyopathy is recommended as follows:
- lean fish and meat, baked, boiled or steamed;
- boiled eggs (no more than 1 per day);
- low-fat dairy products;
- saltless bread and crackers from it;
- weak green or white tea;
- fruits and berries;
- vegetable oil;
- boiled or baked vegetables.
Medication for cardiomyopathy is based on its form.
The treatment strategy for this pathology is as follows:
- Reduce the degree of heart failure and, if possible, to a zero degree. For this, drugs of the “angiotensin-converting enzyme inhibitors” group are used: Enalapril, Lisinopril or others. Firstly, these drugs contribute to the preservation of the original forms by the heart muscle (that is, prevent further expansion and stretching of the myocardium), and secondly, they reduce compensatory increased pressure.
- Reducing myocardial oxygen demand with beta-blockers: Metoprolol, Nebivolol, Carvedilol and others. Therapy begins with minimal doses of these medicines.
- Diuretic drugs – to reduce the amount of water in the vessels, which represents an additional burden on the heart.
- Blood thinners: Cardio-magnesium, Aspecard.
Here it is necessary to improve myocardial contractility, and at the same time reduce its oxygen demand. To do this, apply:
- antiarrhythmic drugs, for example, disopyramids or verapamil;
- blood thinners (cardio-magnesium, aspecard).
The setting of a pacemaker for two-chamber continuous rhythm control is also shown. And in severe cases, a resection of the hypertrophic portion of the interventricular septum can be performed.
This type of disease, if it is of a primary nature, is the most difficult to treat. Only symptomatic agents are used here. Previously, heart transplantation was used, but it had only a temporary effect, since the same pathology again appeared in the transplanted heart.
If restrictive cardiomyopathy developed due to hemochromatosis, sarcoidosis, or other pathology, then in the treatment of a causative disease (for example, sarcoidosis with corticosteroids, and hemochromatosis with bloodletting), a decrease in the degree of heart failure was noted.
Measures for the treatment of cardiomyopathy in young children and adults are mainly aimed at improving the general clinical condition, reducing the manifestations of heart failure, increasing resistance to physical stress, and improving quality of life.
The management protocol for patients with DCMP divides the treatment methods into mandatory and additional.
- Etiotropic treatment for secondary ILC:
- surgical elimination of the cause (ischemic, endocrine CMP);
- etiological therapy of inflammatory ILC.
- Prescribing drugs for the correction of systolic heart failure:
- ACE inhibitors for a long time;
- cardiac glycosides;
- aldosterone antagonists.
Additional (if available):
- Amiodarone with ventricular extrasystoles;
- Dopamine, dobutamine;
- Implantation of a cardioverter defibrillator;
- Heart transplantation.
Patients with HCMP are prescribed:
- Beta blockers;
- Calcium channel blockers;
- Antiarrhythmic drugs;
- Extra charges:
- ACE inhibitors;
- Operative myomectomy;
- implantation of a pacemaker or cardioverter defibrillator.
For the treatment of RKMP, glucocorticosteroids (prednisone), cytostatics and immunosuppressants are used. In the case of severe fibrosis, an endocardectomy with valve replacement is performed.
Treatment of arrhythmogenic right ventricular CMP is aimed at eliminating and preventing arrhythmias. Use cordarone, beta blockers. In case of inefficiency – implantation of an automatic cardioverter-defibrillator, radio-frequency destruction of the arrhythmogenic zone, installation of an artificial pacemaker. In severe cases, a ventriculotomy is performed.
Quality treatment criteria:
- Decreased severity of heart failure symptoms;
- An increase in left ventricular PV;
- Elimination of signs of fluid retention in the body;
- Improving the quality of life;
- Extension of intervals between hospitalizations.
Cardiomyopathy is treated with drugs with different targeted effects. These include:
- beta-blockers (“Atenolol”, “Bisoprolol”);
- anticoagulants – means that normalize the heart rhythm;
- calcium channel blockers;
The choice of optimal treatment tactics depends on the individual characteristics of the patient, concomitant diseases and pressure reactions.
When the treatment course with medicines does not give the expected effect, surgical intervention is required. If cardiomyopathy is combined with a violation of the heart rhythm, then the patient is shown the implantation of a pacemaker. With it, heartbeats will occur at the required frequency.
When there is a risk of rapid death, a defibrillator is implanted. A device of this type is able to coordinate the work of the heart muscle during ventricular fibrillation.
A severe form of pathology that cannot be treated with surgical methods can only be eliminated through heart transplantation.
A favorable prognosis can be safely said in the presence of hypertrophic cardiomyopathy. A person continues to live fully, provided that supportive drugs prescribed by the protocol are used.
The situation is worse with the prognosis of a restrictive or dilated form of the disease. After their discovery, the patient is assigned a disability. According to statistics, in 70% of cases, patients die within 5 years. Typically, such patients require a heart transplant.
The prognosis largely depends on how effective the treatment is and whether the patient follows the recommendations of a cardiologist. As a preventive measure, you should adhere to proper nutrition and a healthy lifestyle.
Cardiopathy is a dangerous disease that occurs in both adults and children. It is acquired, and the causes of the appearance can still not be precisely named. In 70% of cases, the disease leads to a significant decrease in working capacity, and in the absence of timely treatment, it can be fatal.
What is cardiopathy? At the heart of the onset of the disease are disorders in the cardiomyocyte metabolism system, leading to an increase in heart size and a deterioration in its contractility.
Pathology is characterized by dystrophic and sclerotic changes in myocardial tissue.
In this case, the connective tissue begins to replace the heart, as a result of which the myocardium becomes thinner and scars form.
In adults, the disease in most cases is acquired throughout life, and in children it is congenital and can occur from an early age. The danger is that at an early stage of development, the disease can be asymptomatic or with standard ailments that are attributed to overwork:
- heart rhythm disorder.
As a result, the disease progresses rapidly and there is a high risk of developing thromboembolism and malignant heart failure. Therefore, it is important that you consult a specialist immediately if you notice symptoms.
Cardiomyopathy of the heart is a concept that unites a group of diseases that appear for an unknown reason and develop individually in each patient. The disease is not associated with the formation of a tumor or an inflammatory process in the myocardium.
Among the main factors for the appearance of the disease, there are:
- Heredity. Congenital pathology of the development of one of the proteins involved in myocardial work leads to loss of functionality of the entire heart muscle. In this case, the cause of the disease is difficult to establish, the disease is congenital.
- The effect of a toxin or virus. Bacteria and fungi, entering the body, disrupt the DNA chain, change their structure and cause the development of heart muscle disease. Pathologies of the coronary arteries and heart valve are not observed.
- Autoimmune abnormalities. When a virus becomes infected, the body begins to produce antibodies, which can lead to the destruction of their own cells. If the attack occurs on the cells of the heart muscle, then it is impossible to cure the disease.
- Idiopathic fibrosis. Due to the development of cardiosclerosis, cells are replaced by connective tissue. Due to inelasticity, they lose their functionality and stop contracting.
In addition to the above factors, there are a number of diseases against which cardiomyopathy may appear:
- Coronary artery disease. Due to clogging with cholesterol deposits, the narrowing of the coronary arteries occurs, blood circulation is disturbed. The heart muscle ceases to receive enough air, the cells begin to die, and their place is taken by connective tissue.
- Infectious diseases. During the development of the inflammatory process, myocarditis begins to occur, causing cell death.
- Arterial hypertension. Increased arterial pressure exerts an additional burden on the distracting function of the heart, which leads to a loss of elasticity of the vessel walls.
- Disruption of the endocrine glands. With an imbalance of hormones in the body, a malfunction occurs, the heart rate rises and blood pressure rises, as a result of which the myocardial functionality decreases.
- Intoxication. The various components that make up the drugs can affect the myocardium and change its structure. This also applies to alcohol or heavy metal poisoning.
Due to the lack of knowledge of the disease, doctors can only cope with the symptoms of cardiomyopathy. The elimination of the factors that caused it is not possible.
Types of Cardiomyopathy
When establishing a diagnosis, a cardiologist, paying attention to the symptoms and causes, determines the type of disease for the most effective treatment.
Cardiopathy can be primary and secondary. In the first case, it is congenital or appears due to unknown (idiopathic) causes. The disease is characterized by a wide range of ailments and a large number of changes in the structure of the heart muscle.
The secondary one occurs after the past complications of diseases associated with metabolic disorders (for example, diabetes mellitus). The prognosis in this case depends on whether the results of therapy of the underlying disease are positive.
Types of cardiomyopathy and the causes of the disease – who is at risk?
Adult cardiomyopathy includes any disease that occurs with myocardial damage. Therefore, there are plenty of reasons for development. If the abnormal heart function is caused by another diagnosed disease, then they talk about secondary (non-specific) cardiomyopathy. Sometimes the root cause of the pathology remains unknown. In this case, the primary form of the disease is noted.
The main causes of the disease include:
- Viral infection. As a result of numerous studies, experts have found that viral infections are to blame for the occurrence of cardiomyopathy. This fact was confirmed by the presence of appropriate antibodies in patients. The structure of cardiomyocytes can be disrupted by the influence of the Coxsackie virus, cytomegalovirus and hepatitis C. The probability of myocardial damage by an autoimmune process is not ruled out. In this condition, antibodies produced by the body fight their own cells.
- Hereditary factor. Some genetic malfunctions can provoke the development of cardiomyopathy. In cardiomyocytes there is a huge amount of proteins that play an important role in the contractile process. Congenital anomaly of one of them entails a disruption of the heart muscle.
- Myocardial fibrosis of unknown origin. In this case, in place of muscle cells, connective tissue grows. This process is also called cardiosclerosis. Over time, the elasticity of the walls of the heart decreases, resulting in an abnormal muscle contraction. This leads to complete dysfunction of the main organ responsible for blood circulation in the human body.
- Autoimmune disorders. The launch of this mechanism can be caused not only by the presence of viruses in the body, but also by various pathological conditions. Moreover, stopping heart damage provoked by an autoimmune disorder is very problematic. In this case, cardiopathy continues to progress, so it is difficult to talk about a favorable prognosis.
Its first signs can be noted even at the age of 30 years. Presumably, infections, toxic damage, hormonal imbalance, metabolic disorders can provoke the development of this disease. In 15% of cases, dilated cardiomyopathy is hereditary. It is accompanied by such a clinic:
- asthma attacks
- pulmonary edema;
- enlarged liver;
In this case, the patient may deform the chest. To assess the condition of the patient, an examination in the form of electrocardiography and x-ray is prescribed.
Complications of Cardiomyopathies
There are six life-threatening complications that cardiomyopathy can entail.
- Heart failure. It can be systolic and diastolic. In the first case, we are talking about the impossibility of the heart to contract normally, and in the second ventricle, it receives less blood enriched with oxygen.
- Myocardial infarction. This condition occurs against the background of the death of some part of the myocardium, provoked by insufficient blood supply.
- Thromboembolism. Blood clots appear due to stagnation of blood caused by myocardial damage.
- Arrhythmias. When the sequence of myocardial contraction is disrupted, the tissues suffer from oxygen starvation. Arrhythmia occurs as a result of malfunctioning of the conductive system, which causes the heart to beat irregularly, slowly or irregularly.
- Pulmonary edema. If the left side of the heart suffers from congestion, an excess of blood remains in the blood vessels that lead to the lungs. Gradually, the blood vessels become wider, and blood plasma penetrates the lung tissue.
- Instant cardiac death.