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Cardiomyopathy

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Cardiomyopathy refers to a group of diseases that affect the heart muscle (myocardium), leading to its dysfunction. The heart muscle may become enlarged, thick, rigid, or scarred, which can affect the heart’s ability to pump blood effectively. Cardiomyopathy can lead to heart failure, arrhythmias, and other complications.

Types of Cardiomyopathy

  • Dilated Cardiomyopathy (DCM):

  • The heart’s ventricles (usually the left) enlarge and weaken, reducing the heart’s ability to pump blood efficiently.

  • Common causes include genetic factors, viral infections, alcohol abuse, and chemotherapy drugs.

  • Symptoms often include fatigue, shortness of breath, and swelling in the legs and ankles.

  • Hypertrophic Cardiomyopathy (HCM):

  • Characterized by abnormal thickening of the heart muscle, particularly the septum (the wall between the heart chambers), which can obstruct blood flow.

  • It is often inherited and can cause arrhythmias and sudden cardiac arrest, especially in young athletes.

  • Symptoms may include chest pain, fainting, and palpitations.

  • Restrictive Cardiomyopathy:

  • The heart muscle becomes rigid and less elastic, restricting the heart’s ability to fill with blood between beats.

  • It is the least common type and can be caused by conditions like amyloidosis, sarcoidosis, or hemochromatosis.

  • Symptoms include fatigue, shortness of breath, and swelling in the extremities.

  • Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC):

  • A rare form where the muscle tissue in the right ventricle is replaced by fatty or fibrous tissue, leading to arrhythmias.

  • It is often genetic and can cause palpitations, fainting, or sudden cardiac arrest, particularly in young adults.

  • Takotsubo Cardiomyopathy (Stress Cardiomyopathy or “Broken Heart Syndrome”):

  • A temporary condition often triggered by extreme emotional or physical stress.

  • It mimics a heart attack but is usually reversible, with no permanent damage to the heart muscle.

  • Symptoms include chest pain and shortness of breath.

Causes-Risk factors-Symptoms

  • Genetic Factors: Many forms, particularly HCM and ARVC, are inherited.

  • Chronic conditions: Such as hypertension, diabetes, or thyroid disorders.

  • Viral infections: Can cause inflammation of the heart muscle.

  • Toxins: Including alcohol, cocaine, and certain chemotherapy drugs.

  • Nutritional deficiencies: Such as thiamine deficiency in alcoholics (beriberi heart disease).

  • Autoimmune diseases: Conditions like lupus or scleroderma.

  • Prolonged high blood pressure: Can strain and enlarge the heart muscle.

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  • Shortness of breath: Particularly with exertion or when lying flat.

  • Fatigue: Due to reduced heart function.

  • Swelling (Edema): In the legs, ankles, feet, or abdomen.

  • Chest pain or pressure: Especially in HCM.

  • Palpitations: Irregular or rapid heartbeats.

  • Dizziness or fainting: Particularly in HCM or ARVC due to arrhythmias.

  • Reduced ability to exercise.

Diagnosis-Treatment

  • Echocardiogram: Ultrasound imaging to assess heart size, structure, and function.

  • Electrocardiogram (ECG): Measures electrical activity of the heart to detect arrhythmias or abnormalities.

  • MRI or CT scan: Provides detailed images of the heart’s structure and any scarring.

  • Genetic testing: For inherited forms of cardiomyopathy.

  • Cardiac catheterization: To measure pressures inside the heart chambers and examine the coronary arteries.

  • Biopsy: Rarely, a sample of heart tissue is taken to identify specific causes of cardiomyopathy.

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  • Medications:

    • Beta-blockers: To reduce heart rate and blood pressure, easing heart workload.

    • ACE inhibitors or ARBs: To lower blood pressure and reduce strain on the heart.

    • Diuretics: To reduce fluid build-up and ease symptoms of heart failure.

    • Antiarrhythmics: To control abnormal heart rhythms.

    • Anticoagulants: To reduce the risk of blood clots.

  • Implantable Devices:

    • Pacemakers: To help regulate slow or irregular heartbeats.

    • Implantable Cardioverter-Defibrillators (ICDs): To prevent sudden cardiac arrest by correcting life-threatening arrhythmias.

    • Cardiac Resynchronization Therapy (CRT): Helps the heart’s chambers pump in a more coordinated manner.

  • Surgical Interventions:

    • Septal Myectomy: For HCM, to remove part of the thickened septum that obstructs blood flow.

    • Heart Transplant: In severe cases where the heart’s function is significantly impaired and other treatments have failed.

  • Lifestyle Modifications:

    • Dietary changes: Low-sodium diet to reduce fluid retention.

    • Exercise: As recommended by a healthcare provider, avoiding strenuous activities in some forms like HCM.

    • Avoiding alcohol and stimulants: To prevent further damage to the heart.

Complications-Prognosis

  • Heart failure: The heart becomes too weak to pump blood effectively.

  • Arrhythmias: Abnormal heart rhythms that can be life-threatening.

  • Blood clots: Increased risk of stroke or pulmonary embolism.

  • Cardiac arrest: Sudden stopping of the heart, especially in HCM and ARVC.

    The prognosis varies depending on the type, severity, and underlying cause of cardiomyopathy. With appropriate treatment and lifestyle adjustments, many people can manage symptoms and maintain a good quality of life. However, some cases may progress to severe heart failure or require a heart transplant. Regular monitoring and follow-up with a cardiologist are essential for managing the condition effectively.

Need more details?

We are here to assist. Contact us at CuraNation.
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