What Is Cardiomyopathy? Symptoms, Causes And Why Early Diagnosis Matters
· Free Press Journal
When we think about heart disease, heart attacks and blocked arteries are usually the first conditions that come to mind. But the heart can be affected in several other ways, including conditions that may develop much earlier in life. Cardiomyopathy is one of them.
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What is cardiomyopathy?
Cardiomyopathy is a condition in which the heart muscle’s ability to pump and/or relax becomes impaired. When the heart is unable to function properly, patients may experience symptoms such as breathlessness, swelling of the legs or abdomen, persistent cough and wheezing.
The clinical symptoms that result from underlying cardiomyopathy are referred to as “heart failure”.
Heart failure is one of the top three leading causes of death reported in the Western world. More importantly, India-based population studies over the last two decades have shown that Indian patients are developing heart failure at a much younger age than their counterparts in the Western world.
Cardiomyopathy itself is not restricted to a particular age group. Depending on the underlying cause, it can present at any stage of life. Several cardiomyopathies linked to genetic disorders can present during the first three to four decades of life.
Other forms can occur at different ages. For instance, cardiomyopathy related to a heart attack or diabetes can present at any age, depending on the individual’s underlying risk factors.
Symptoms
One of the challenges with cardiomyopathy is that its symptoms can initially appear nonspecific. Breathlessness, a persistent cough, swelling or a reduced ability to tolerate physical activity may not immediately be recognised as signs of an underlying heart condition.
As a result, these symptoms may sometimes be attributed to age, lifestyle or simply being out of shape, potentially delaying evaluation and diagnosis. When several of these symptoms occur together or persist without an obvious explanation, they should not be ignored.
Does the cause matter?
Cardiomyopathy can have different underlying causes, and understanding the cause is important because different forms may require different approaches to management.
A detailed clinical evaluation can help doctors determine whether factors such as genetic conditions, a previous viral infection, pregnancy, exposure to drugs or toxins, a heart attack, diabetes or another underlying factor may be contributing to the condition.
Early diagnosis
If someone is diagnosed with cardiomyopathy, they should consult a cardiologist specialising in cardiomyopathy and heart failure. Prompt diagnosis and early initiation of evidence-based medical therapy can dramatically alter the clinical trajectory.
Timely treatment can help prevent the condition from progressing to more advanced stages, where patients may require interventions such as defibrillator implants, artificial heart pump surgery or even heart transplant surgery.
Treatment & prevention
Treatment of cardiomyopathy is centered around a combination of carefully titrated medications to help the heart muscle recover. It is equally important to look for any reversible causative factors for the cardiomyopathy which when corrected could help improve the heart function.
Further, participation in a cardiac rehabilitation program helps the patients recover their exercise potential sooner and prevent chances of re-hospitalizations.
Automated defibrillator implants to prevent sudden cardiac death may be indicated on a case to case basis.
In rare cases, patients could potentially progress to a condition called advanced heart failure which would require surgical therapies such as artificial heart pump (Left Ventricular Assist Device) implantation or heart transplant surgeries.
Consultation with a cardiologist must be sought if one has any of the symptoms listed above or if they are diagnosed with cardiomyopathy irrespective of their symptoms
The takeaway
Cardiomyopathy is not confined to older adults or people with an obvious history of heart disease. It can affect younger adults as well, and its causes can vary considerably.
Recognising persistent or unexplained symptoms and seeking medical evaluation early can help identify the underlying cause and allow appropriate treatment to begin before the disease progresses to advanced heart failure and its associated complications
(Dr. Talha Meeran, Additional Director & Head of the Heart Failure Program, Division of Advanced Cardiac Sciences & Cardiac Transplant, Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai)