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Cardiomyopathy

• Overview
• Symptoms
• Treatment

Treatment:

While all types of cardiomyopathy can cause heart failure, each case requires specific strategies for recovery. Heart failure is treated with a vigorous blend of patient education, dietary changes, and medications.

Possible medications include:

• Positive inotropic medications: These medicines help the heart contract. Digoxin is one type of positive inotropic medication. It is no longer widely used, except in cases complicated by atrial arrhythmias. Other medicines have replaced digoxin. Positive inotropic medications given to patients in the hospital include dopamine, dobutamine, and milrinone.
• Diuretics: Often called "water pills," diuretics help relieve the fluid overloads in heart failure.
• Vasodilators: These drugs dilate blood vessels at several levels in the body, reducing the workload for the heart.
• ACE-inhibitors and angiotensin receptor blockers (ARBs): These drugs have been shown to improve survival and reduce heart-related complications.
• Aldosterone blockers : These drugs help balance electrolytes in the body. Studies have shown that aldosterone blockers can improve survival in patients who have a heart attacked complicated by cardiomyopathy.
• Beta blockers : In the past, these drugs were not recommended for those with cardiomyopathy. However, beta blockers are now becoming more widely used for the treatment of congestive heart failure, particularly when it is severe. Beta blockers slow the heart rate.
• Other drugs:  Antiarrhythmic drugs and blood thinners may also be used.

In some individuals with severely weak pumping function of the heart and severe heart failure, a special pacemaker, called a biventricular pacemaker, may be needed. It makes the contraction of the left and right bottom chambers (ventricles) more efficient. In very specific cases, biventricular pacemakers with defibrillation functions are used.

In severe cases, surgical procedures, which can be implemented to sustain life until a transplant donor becomes available, can help but do not cure the disease. They include:

• Left Ventricular Assist Device (LVAD): Treatment provides mechanical circulatory support.
• Dynamic Cardiomyoplasty: A procedure in which a skeletal-muscle flap, created from a patient's thoracic (chest) muscle, is trained to contract often and "wrapped around" the heart to help it contract.

Advanced, severe heart failure requires heart transplant.

Expectations (prognosis):

How well a patient does depends on many different things, including the severity of the heart problem, what is causing the cardiomyopathy, and how well the patient responds to treatment.

The disorder is chronic (long-term)and the condition may get worse very quickly.

Complications:

• Heart failure
• Arrhythmia

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if symptoms indicating heart failure develop, or if chest pain is present and not relieved by rest or medication.

• 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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