Myocardiopathy: what is it and how to treat it?
Myocardiopathy refers to diseases of the heart muscle, in which the walls of the heart chambers are stretched, thickened or stiffened
This affects the heart’s ability to properly pump blood throughout the body.
The nature of myocardiopathy
The heart muscle modified by myocardiopathy, which is usually hereditary and can occur in both children and young adults, can differ depending on the nature of the myocardiopathy.
Let us analyse below the differences between dilated myocardiopathy, hypertrophic myocardiopathy, restrictive myocardiopathy and right ventricular arrhythmogenic myocardiopathy.
In dilated myocardiopathy, the muscular walls of the heart stretch and thin, and are therefore no longer able to contract properly to pump blood throughout the body.
How serious is it?
If you have dilated myocardiopathy, you are at increased risk of heart failure: in essence, your heart cannot pump enough blood throughout your body at the right pressure.
This can have very serious consequences.
Heart failure usually causes
- shortness of breath
- extreme tiredness
- swelling of the ankles
There is also a risk of developing heart valve problems, which leads to irregular heartbeat and blood clots.
If you suffer from myocardiopathy, you should make regular visits with a doctor to keep your health condition monitored.
Who can suffer from myocardiopathy?
Dilated myocardiopathy can affect both children and adults.
There are certain conditions that can lead to developing it, such as:
- inheriting a modified gene that makes you more vulnerable to the condition;
- an underlying medical condition;
- uncontrolled high blood pressure;
- an unhealthy lifestyle, such as a lack of vitamins and minerals in the diet, drinking too much alcohol and consuming drugs;
- a viral infection that causes inflammation of the heart muscle;
- a heart valve problem;
- a tissue or blood vessel disease – such as granulomatosis with polyangiitis (GPA), sarcoidosis, amyloidosis, lupus, polyarteritis nodosa, vasculitis or muscular dystrophy;
- pregnancy: myocardiopathy can sometimes develop as a complication of pregnancy.
In many cases, however, the cause of the development of dilated myocardiopathy remains unknown.
In hypertrophic myocardiopathy, the heart muscle cells enlarge and the walls of the heart chambers thicken.
The heart chambers are small in size, so they cannot hold much blood, and the walls cannot relax properly and may stiffen.
In addition, the flow of blood through the heart may be obstructed.
How serious is it?
In most cases, hypertrophic myocardiopathy does not have a great impact on daily life.
Some people have no symptoms at all, and do not need treatment.
But this does not mean that the condition cannot be serious.
Hypertrophic myocardiopathy is in fact the most common cause of sudden death in childhood and young athletes, precisely because it remains asymptomatic for a long time.
This happens because the main cardiac chambers can stiffen, causing back pressure on the smaller collecting chambers.
This can sometimes worsen the symptoms of heart failure and lead to abnormal heart rhythms (atrial fibrillation).
The blood flow coming from the heart may be reduced or restricted (in this case we speak of hypertrophic obstructive myocardiopathy).
These cardiac changes can cause dizziness, chest pain, shortness of breath and temporary loss of consciousness.
If you suffer from severe hypertrophic myocardiopathy, you should consult your doctor regularly so that your condition can be constantly monitored.
Your doctor will advise you on the level and amount of exercise you can do, as well as the changes you should make in your lifestyle.
Who suffers from it?
Hypertrophic myocardiopathy is believed to be hereditary in origin.
Children are therefore affected from birth.
Restrictive myocardiopathy is a very rare condition.
It is most often diagnosed in children, although it can develop at any age.
The walls of the main cardiac chambers become rigid and therefore cannot relax properly after contraction.
This means that the heart does not fill adequately with blood.
This results in reduced blood flow to the heart, and can lead to heart failure symptoms such as shortness of breath, fatigue and swelling in the ankles, as well as heart rhythm problems.
In many cases, the cause remains unknown, although the condition may be hereditary.
Right ventricular arrhythmogenic myocardiopathy
In arrhythmogenic right ventricular myocardiopathy (ARVC), the proteins that usually hold heart muscle cells together are abnormal.
Muscle cells may die and the dead muscle tissue is replaced with fat and fibrous tissue.
The walls of the main heart chambers become thinner and longer, and are unable to pump blood properly throughout the body.
People with right ventricular arrhythmogenic myocardiopathy usually have heart rhythm problems.
Reduced blood flow to the heart can also lead to symptoms of heart failure.
Right ventricular arrhythmogenic myocardiopathy is an inherited condition caused by a mutation in one or more genes.
It can affect adolescents or young adults, and is unfortunately the reason for some sudden and unexplained deaths in young athletes.
There is scientific evidence that prolonged and intense exercise can worsen the symptoms of right ventricular arrhythmogenic myocardiopathy.
It is important that people at risk or with the condition discuss this with their cardiologist.
How is myocardiopathy diagnosed
Some cases of myocardiopathy can be diagnosed after various cardiac scans and tests, such as:
- electrocardiogram (ECG)
- MRI scan
- heart rate monitor (24 or 48-hour ECG monitor)
- stress test
If you have been diagnosed with a myocardiopathy of genetic origin, your doctor may recommend a genetic test to identify the defective gene that caused it.
In this way, your relatives will also be aware of a possible asymptomatic myocardiopathy, and they will be able to manage it, monitor it and check their health condition.
How to treat myocardiopathy
There is usually no cure for myocardiopathy, but treatments can be effective in controlling symptoms and preventing complications.
Some types of myocardiopathy have specific treatments and early diagnosis is very important.
However, not everyone who suffers from myocardiopathy will need treatment: some people only have a mild form of the condition, and they can keep it under control by merely changing their lifestyle.
The role of lifestyle in myocardiopathy
Whether the cause of myocardiopathy is genetic or not, a good rule of thumb would be to adopt good habits, such as
- healthy diet
- gentle exercise
- stop smoking
- losing weight
- reduce or eliminate alcohol
- get enough sleep
- reduce stress
- ensure that any additional pathologies, such as diabetes, are under control
What medicines to take for myocardiopathy
In myocardiopathy, drugs may be needed to control blood pressure, correct an abnormal heart rhythm, remove excess fluid or prevent the formation of blood clots.
This refers to drugs such as
- blood pressure medications
- beta-blockers to treat an irregular heartbeat or heart failure
- diuretics – for high blood pressure
- medicines for treating heart failure