Cardiomyopathy: Information & cardiomyopathy specialists

Leading Medicine Guide Editors
Author
Leading Medicine Guide Editors

Cardiomyopathy is a disease of the heart muscle in which its tissue changes. The causes and symptoms of such a disease can vary greatly. Shortness of breath, chest pain and rapid palpitations are just some of the symptoms that can occur. Cardiac output decreases and the symptoms of heart failure appear.

Here you will find further information and selected cardiomyopathy specialists and centers.

ICD codes for this diseases: I42, I43

Recommended specialists

Article overview

What forms of cardiomyopathy are there?

There are primary and secondary cardiomyopathies. Primary cardiomyopathies develop directly in the heart muscle. Secondary cardiomyopathy occurs when other diseases damage the heart muscle tissue.

Cardiomyopathy can be divided into five types with regard to the changes in heart muscle structure and function:

  • Dilated (enlarging) cardiomyopathy: most common form of cardiomyopathy, characterized by an enlarged ventricle and a greatly reduced pumping function of the heart.
  • Hypertrophic (enlarged) cardiomyopathy (HCM): Second most common form of cardiomyopathy. It is genetic and runs in families. The heart muscles are too thick and no longer sufficiently elastic. The diameter of the heart chamber is normal or reduced, the pumping function is normal. This form of cardiomyopathy can also be obstructive(HOCM), in which case the blood flow through the thickened heart muscle is impaired.
  • Restrictive cardiomyopathy: Rare form, the exact causes are not known. The body builds up more connective tissue in the muscle, the ventricular walls harden and can no longer expand far enough. Less blood flows from the atrium into the ventricle. This results in blood congestion and the atria become larger. The ventricles themselves retain their normal size and are able to continue pumping normally for the most part.
  • Arrhythmogenic right ventricular cardiomyopathy: Affects the right ventricle and can trigger cardiac arrhythmia during physical exertion. The cause is unknown. Some of the cells in the right ventricle die off and are replaced by fatty and connective tissue. The muscle tissue becomes thinner and the heart's conduction system is affected. Young, male athletes are often affected.
  • Hypertensive cardiomyopathy: Chronic high blood pressure triggers this form. The heart pumps more vigorously due to the higher resistance in the arteries. As a result, the left ventricle becomes increasingly thickened and loses efficiency.

Other heart muscle diseases include non-compaction cardiomyopathy. In this congenital form, only the left ventricle is affected. The muscles appear distended like a sponge in the ultrasound image. Remodeling processes cause scarring of the heart muscles, the heart chambers enlarge and can no longer work adequately.

Stress cardiomyopathy is caused by severe emotional or physical stress. It is also known as broken heart syndrome or Tako-Tsubo cardiomyopathy.

Hypertrophe Kardiomyopathie
In the hypertrophic form of cardiomyopathy, the heart muscle is thickened © Akarat Phasura | AdobeStock

Causes of cardiomyopathy

Primary cardiomyopathies, which develop directly in the heart muscle, are often genetic. Inherited cardiomyopathies have often existed since birth and symptoms usually only appear later.

Numerous diseases can damage the heart muscle. Medication, such as anti-cancer drugs, can also trigger cardiomyopathy.

Possible causes include

If the doctor recognizes the cause of the cardiomyopathy, he can initiate therapy. This can prevent the disease from progressing rapidly.

Symptoms of cardiomyopathy

The symptoms vary depending on the form of cardiomyopathy. The time at which symptoms occur at all also depends on the type of cardiomyopathy. In some cases, cardiomyopathy can remain undetected for a long time.

In every form of cardiomyopathy, the heart muscle tissue (myocardium) changes. The function and performance of the heart decreases. Patients suffer from different symptoms, depending on the respective form and severity.

In all forms of cardiomyopathy, certain parts of the heart muscle or the entire muscle are no longer able to perform. This leads to typical symptoms.

Cardiac arrhythmia

The body needs more oxygen. This increases the heart rate, the heart beats faster and often irregularly. This results in heart palpitations. In addition, attacks of dizziness or even brief fainting spells often occur.

Fatigue

The heart cannot pump enough oxygen-rich blood into the arteries and brain. As a result, patients feel exhausted, tired and confused. The slowed blood flow causes the tissue to draw more oxygen from the blood.

Cold and bluish discolored areas of skin, especially on the hands and feet, are typical signs of this.

Water retention

The weakened performance of the heart causes blood to accumulate in the pulmonary vessels and veins. Fluid leaks into the body and lung tissue. Edema (water retention) develops in the lungs, and the liver, kidneys and stomach can also be affected.

Pain in the right upper abdomen, a feeling of bloating and loss of appetite are the result.

Bluish discoloration of the skin

The initial phase of pulmonary oedema is characterized by increased coughing. As it progresses, patients find it increasingly difficult to breathe. They become short of breath and cough up foamy secretions.

If too much fluid is stored in the lung tissue, the blood no longer absorbs enough oxygen. In the case of severe heart failure, the lips or tongue often appear bluish in color (cyanosis).

If you experience one or more of the symptoms described, consult a heart specialist soon. If the disease is treated in time, its rapid progression can be halted.

Possible complications

With cardiomyopathy, there is a risk of blood clots forming on the inner walls of the heart. The heart's pumping function is more irregular and weaker than in a healthy state. This causes vortices to form in the heart chambers, sometimes resulting in blood clots. Blood clots are small clusters of blood cells.

Under certain circumstances, the blood clots can break loose and then travel with the bloodstream to other organs. In the worst case, such a blood clot can block an important blood vessel there and thus trigger pulmonary embolisms or strokes.

In rare cases, cardiac arrhythmias suddenly become so severe that the entire circulatory system collapses. The heart beats so fast that the heart chambers no longer fill with enough blood between the individual beats. The result can be sudden cardiac death.

Examination and diagnosis

Listening to the heart gives the cardiologist the first clues. Blood tests show antibodies and markers for heart failure (proBNP) in the event of illness. They help to diagnose possible heart damage.

Various procedures are used to make the diagnosis.

  • Echocardiography (ultrasound examination of the heart): Shows the mobility and thickness of the heart muscle. This enables the doctor to detect diseases of the heart valves. He can also check whether the heart is pumping enough blood into the body's circulation.
  • ECG (electrocardiogram, e.g. exercise ECG) measures the electrical activity of the heart. Cardiac arrhythmias are detected.
  • During a cardiac catheterization, the heart specialist inserts a thin plastic tube into the heart via a blood vessel. This allows the pressure in the blood vessels close to the heart and in the individual areas of the heart to be measured.
  • Biopsy of the heart muscle: During a cardiac catheterization, the doctor can take a tissue sample. The sample is examined microscopically in the laboratory to identify the structure or changes in the muscle.
  • Imaging procedures such as MRI, X-ray or CT scans areused to visualize the heart and make changes visible.
  • Genetic tests can be used to determine whether the patient is affected by genetic mutations.

Treatment options

Medication is used for many forms of cardiomyopathy, e.g. for

  • Autoimmune reactions,
  • disturbed metabolic processes,
  • infections and
  • vitamin deficiency.

Consistent physical rest can prevent further damage.

Medication is also prescribed to treat the symptoms caused. These include

  • Beta-blockers,
  • ACE inhibitors or
  • diuretics.

They relieve the heart. Cardiac arrhythmias are prevented with special antiarrhythmic drugs and beta-blockers. The formation of blood clots is prevented with an anticoagulant. Often only the symptoms can be alleviated and complications avoided.

If an operation is necessary, the heart surgeon removes parts of the heart muscle (myectomy). It may also be necessary to insert a pacemaker or defibrillator.

If all treatments have been exhausted, the last option is a heart transplant.

Course of the disease and prognosis

In most cases, cardiomyopathy is a serious disease that can rarely be cured. In many cases, the deterioration in health cannot be prevented.

The prognosis, also with regard to life expectancy, is strongly related to the respective form and stage of the disease.

Whatsapp Facebook Instagram YouTube E-Mail Print