Cardiomyopathy

Cardiomyopathy is a serious disease in which the heart muscle becomes inflamed and doesn't work as well as it should. There may be multiple causes including viral infections.

Cardiomyopathies can generally be categorized into two groups, based on World Health Organization guidelines: extrinsic cardiomyopathies and intrinsic cardiomyopathies

EXTRINSIC

These are cardiomyopathies where the primary pathology is outside the myocardium itself. Most cardiomyopathies are extrinsic, because by far the most common cause of a cardiomyopathy is ischemia. The World Health Organization calls these specific cardiomyopathies:
• Coronary artery disease
• Congenital heart disease
• Nutritional diseases
• Ischemic (or ischaemic) cardiomyopathy
• Hypertensive cardiomyopathy
• Valvular cardiomyopathy
• Inflammatory cardiomyopathy
• Cardiomyopathy secondary to a systemic metabolic disease
• Alcoholic cardiomyopathy
• Diabetic cardiomyopathy

INTRINSIC

Intrinsic cardiomyopathy has a number of causes including drug and alcohol toxicity, certain infections (including Hepatitis C), and various genetic and idiopathic (i.e., unknown) causes.
• Dilated cardiomyopathy (DCM), the most common form, and one of the leading indications for heart transplantation.
• Hypertrophic cardiomyopathy (HCM or HOCM), a genetic disorder caused by various mutations in genes encoding sarcomeric proteins.
• Arrhythmogenic right ventricular cardiomyopathy (ARVC) arises from an electrical disturbance of the heart in which heart muscle is replaced by fibrous scar tissue. The right ventricle is generally most affected.
• Restrictive cardiomyopathy (RCM) is an uncommon cardiomyopathy. The walls of the ventricles are stiff, but may not be thickened, and resist the normal filling of the heart with blood
• Noncompaction cardiomyopathy has been recognized as a separate type since the 1980s. The term refers to a cardiomyopathy where the left ventricle wall has failed to grow properly from birth and has a spongy appearance when viewed during an echocardiogram.

SIGNS AND SYMPTOMS

Signs and symptoms Cardiomyopathy is usually found incidentally thru
• "case finding" - by healthcare professionals during a routine checkup.
• The only test for hypertension is a blood pressure measurement.
Hypertension in isolation usually produces no symptoms although some people report headaches, fatigue, wanting to sleep more than usual, dizziness, blurred vision, facial flushing or tinnitus.

TREATMENT

• implanted pacemakers
• defibrillators
• ventricular assist devices (LVADs)
• ablation
Treatment of cardiomyopathy (and other heart diseases) using alternative methods such as stem cell therapy is commercially available but is not supported by convincing evidence.