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Cardiomyopathy

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Definition:

Cardiomyopathy is a weakening of the heart muscle or a change in heart muscle structure. It is often associated with inadequate heart pumping or other heart function abnormalities.

Causes, incidence, and risk factors:

Cardiomyopathy can be caused by viral infections, heart attacks , alcoholism, long-term, severe high blood pressure, nutritional deficiences (particularly selenium, thiamine, and L-carnitine), systemic lupus erythematosus, celiac disease, and end-stage kidney disease.

Specific types of cardiomyopathy include:

• Dilated cardiomyopathy : This is a global, usually idiopathic myocardial disorder characterized by a marked enlargement and inadequate function of the left ventricle. It may affect young people. Dilated cardiomyopathy includes many conditions:
  • Ischemic cardiomyopathy : This is caused by heart attacks, which leave scars in the heart muscle (myocardium).
  • Idiopathic cardiomyopathy: The term "idiopathic" means that the cause is unknown.
  • Hypertensive cardiomyopathy: This is seen in people who have high blood pressure for a long time, particuarly when it has gone untreated for years.
  • Infectious cardiomyopathy: HIV, Lyme disease, Chagas disease, viral myocarditis, and other infections have been linked to dilated cardiomyopathy.
  • Alcoholic cardiomyopathy : This type of dilated cardiomyopathy usually begins about 10 years after sustained, heavy alcohol consumption. It can occur with both typical signs of heart failure, as well as with atrial fibrillation or other heart rhythm problems.
  • Toxic cardiomyopathy: In additional to alcohol, cocaine use, and some chemotherapy drugs can also produce dilated cardiomyopathy.
  • Peripartum cardiomyopathy : This type appears in women during the last trimester of pregnancy or after childbirth.
  • Tachycardia mediated cardiomyopathy: This occurs in people who have an abnormally fast heart rate.
• Hypertrophic cardiomyopathy : This occurs when the left and right heart muscles grow to be different sizes. In up to 70% of cases, there is a family history of this condition.
• Restrictive cardiomyopathy : This disorder affects the heart muscle's ability to relax between contractions. The heart cannot relax adequately after each contraction (systole), which prevents it from filling with enough blood.

Dilated cardiomyopathy accounts for over 10,000 deaths each year. Nearly 50,000 people a year are hospitalized due to this condition. The condition may not produce symptoms in some people, or it may be so severe that heart failure develops, which may require a heart transplant .

• Review Date: 5/30/2006
• Reviewed By: Alan Berger, MD, Assistant Professor, Divisions of Cardiology and Epidemiology, University of Minnesota, Minneapolis, MN. Review provided byVeriMed Healthcare Network.

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