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CARDIOMYOPATHY

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What is It? (Right sided/left sided)
What Causes It?
Types of Cardiomyopathy
Symptoms of Cardiomyopathy

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What is it?
Cardiomyopathy is a serious disease of the lower chambers (ventricles) of the heart. (Cardio=meaning heart --- Myopathy=meaning disease). In simple terms, the heart no longer works as good as it should.


What causes Cardiomyopath?
The most common cause is coronary artery disease (CAD), or a viral infection, a hormonal disorder (diabetes, or throid disease), drugs (alcohol, cocaine, and certain antidepressants) heavy drinking and pregnancy. Sometimes the word "idiopathic" is used in conjunction with cardiomyopathy; it merely means that the cause is "unknown."

Following is a complete listing of known causes of cardiomyopathy from Cleveland Clinic Journal of Medicine, Volume 69, Number 6, June 2002:

Electrolyte abnormalities: hypocalcemia, hypophosphatemia, uremia.
Endocrine abnormalities: Cushing disease, diabetes mellitus, growth hormone abnormalities, hypothyroidism/hyperthyroidism, pheochromocytoma.
Hypertension (long-standing)
Infectious causes: bacterial (brucellosis, diphtheria, psittacosis, typhoid fever), fungal, myocobacterial, parasitic (Chagas disease, schistosomiasis, toxoplasmosis), Rickettsial, Viral (coxsackie A and B viruses, cytomegalovirus, Epstein-Barr virus, human immunodeficiency virus, varicella virus)
Infiltrative diseases: Amyloidosis, hemochromatosis, sarcoidosis
Ischemia
Neuromuscular diseases: Duchenne muscular dystrophy, Friedreich ataxia, Myotonic dystrophy
Nutritional abnormalities: Carnitine, Selenium, Thiamine
Rheumatologic diseases: Giant cell arteritis, Scleroderma, systemic lupus erythematosus
Tachyarrhythmias
Toxins: amphetamines, antiretroviral agents, carbon monoxide, chemotherapeutic agents, radiation, chloroquine, phenotiazines, cobalt, lead, mercury, cocaine, ethanol
Valvular heart disease

Left Sided/Right Sided Heart Failure

What affects one side of the heart eventually will effect both sides as the heart and lungs are interconnected systems. Left side failure occurs when left ventricular output is less than the volume of blood received from the right side of the heart via the pulmonary circulation. Congestion in the pulmonary circuit ensues and the systemic blood pressure falls. Myocardial infarction is the most common cause of left heart failure but it can also be caused by hypertension, aortic insufficiency or cardiomyopathy.

Right heart failure, similarly, occurs when the right ventricle cannot pump the volume of blood returned to it. The resulting congestion of the systemic venous system and decreased output to the lungs causes venous distention, swelling of distensible organs to produce hepatomegaly, splenomegaly and peripheral edema. In addition, many of the effects of left heart failure are seen because of the inadequate return from the lungs and output of the left ventricle. The causes of right heart failure are left heart failure, obstructive lung disease, and congenital heart defects.

Symptoms of Cardiomyopathy:
Shortness of breath on exertion and getting tired easily.
Improper valve closure causes murmers that can be heard by a physician.
Abnormal (fast or slow) rhythm of the heart or pulse.
Faintness, chest pain, or palpitations.
Tissue swelling (edema) in ankles, feet, or abdomen.

Four types of Cardiomyopathy: -- Dilated -- Hypertrophic -- Restrictive --and Peripartum:

Dilated Cardiomyopathy refers to the enlargement of the lower chamber of the heart (ventricles) and the inability of the heart to pump enough blood to the body. This is where "ejection fraction" comes from--a normal heart ejection fraction (pumping of blood out of the heart to the rest of the body)-- is generally in the range of 55 to 60%.

Hypertrophic Cardiomyopathy may happen as a result of a birth defect or as a result of acromegaly, (excessive growth hormone in the blood), or a tumor that produces adrenaline. It is any thickening of the muscular walls of the heart. A typical cause is high blood pressure.

Restrictive Cardiomyopathy, while the least common form, is similar to Hypertrophic CM. It's cause is unknown. In some the heart muscle is infiltrated by abnormal material, such as white blood cells, or the heart muscle is gradually replaced by scar tissue. Other causes are amyloidosis and sarcoidosis.

Peripartum Cardiomyopathy is caused by pregnancy and happens during the last month or shortly delivery. We have an excellent link to a wonderful support site called Kim's PPCM Support. Kim is a nurse and a PPCM survivor! (Just click on the link.)

This material was written in "layman's" language with information taken from the American Heart Association and The Merck Manual. It is not medical advice--ONLY YOUR DOCTOR--can give you medical advice.

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Last Modified on October 4, 2002

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