By: Prof. Dr. Seyed Saeid Zamanieh Shahri, MD and Prof. Dr. Sonia Sayyedalhosseini, MD

Definition: Cardiomyopathy (inflammatory disease of the heart muscle) is called heart muscle disease. This disease has different causes, signs and symptoms.

In cardiomyopathy, the heart muscle becomes large, thick, or stiff. In rare cases, the heart muscle tissue is replaced by scar tissue. As the disease worsens, the heart becomes weaker and less able to pump blood through the body and maintain a normal electrical rhythm. This can lead to heart failure or irregular heartbeats which is called arrhythmias. In turn, heart failure can cause fluid to build up in the lungs, ankles, legs or abdomen.

Weakness of the heart can also cause other complications, such as heart valve problems.

Risk Factors for Cardiomyopathy:

People of all ages and races can be affected by cardiomyopathy. However, certain types of disease are more prevalent in certain groups. This type of disease is also more common in men than women. Adolescents and young adults are more likely to develop right ventricular arrhythmogenic dysplasia than the elderly. Although it is a rare disease in both sexes, certain diseases, conditions, or specific factors can increase the risk of cardiomyopathy. Major risk factors include the following:

  • Family history of cardiomyopathy, heart failure or sudden cardiac arrest
  • A specific disease or condition that can lead to cardiomyopathy, such as ischemic heart disease, heart attack, or a viral infection that inflames the heart muscle.
  • Diabetes or other metabolic diseases or severe obesity
  • Diseases that can damage the heart such as hemochromatosis, sarcoidosis or amyloidosis
  • Alcoholism
  • Hypertension disease
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Some people with cardiomyopathy never have any signs or symptoms of the disease. Therefore, it is important to identify people who may be at higher risk for the disease. This can help prevent future problems such as serious arrhythmias (irregular heartbeats).

Types of Cardiomyopathies:

Hypertrophic cardiomyopathy: Hypertrophic cardiomyopathy is very common and can affect people of any age. This type of disease affects men and women equally, and about 1 in 500 people get the disease. Hypertrophic cardiomyopathy occurs when the heart muscle becomes large and thick for no apparent reason. The ventricles and septum (the wall that separates the left and right sides of the heart) usually thicken. Thickened areas narrow ventricles or restricts them, making it difficult for the heart to pump blood. Hypertrophic cardiomyopathy can also cause ventricular stiffness, mitral valve changes, and cellular changes in heart tissue.

Dilated cardiomyopathy: Dilated cardiomyopathy is caused by enlarged and weakened ventricles. It usually starts in the left ventricle and can affect the right ventricle over time. Weak heart chambers do not pump effectively and cause the heart muscle to work harder. Over time, the heart loses the ability to pump blood efficiently. Dilated cardiomyopathy leads to heart failure, heart valve disease, irregular heartbeat, and blood clots in the heart.

Restrictive cardiomyopathy: Restrictive cardiomyopathy occurs when the ventricles become stiff but the walls of the heart do not thicken. As a result, the ventricles do not relax and fill with normal blood volume. As the disease progresses, the ventricles do not pump and the heart muscle becomes weak. Over time, restrictive cardiomyopathy can lead to heart failure and heart valve problems.

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Arrhythmogenic Right ventricular Dysplasia (ARVD): Right ventricular arrhythmogenic dysplasia is a rare form of cardiomyopathy and occurs when muscle tissue in the right ventricle is replaced with adipose tissue or fiber. This can interfere with the heart’s electrical signals and cause arrhythmias. Right ventricular arrhythmogenic dysplasia usually affects adolescents or young adults and can cause sudden cardiac arrest in young athletes. Symptoms include palpitations and fainting after physical activity.

Unclassified cardiomyopathy: Other types of cardiomyopathies fall into this category and can include the following:

Takotsubo cardiomyopathy, or broken heart syndrome, occurs when severe stress leads to heart muscle failure. Although rare, it is more common in postmenopausal women.

Signs and symptoms of cardiomyopathy:

Some people with cardiomyopathy never have any signs or symptoms. To be continued

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