Cardiomyopathy Treatment

  • Treatment

    If you are suddenly short of breath, have chest pains, or faint during physical activities, seek immediate medical attention. Cardiomyopathy is a serious medical condition. If you experience heart pounding, unexplained breathlessness, or sudden chest pain, see a doctor right away.

    Talk to your doctor about specific diet, exercise, and weight loss measures that may help your condition. If you have been diagnosed with cardiomyopathy, you should not drink any alcohol at all. Your doctor may also recommend that you lose weight if you are overweight, and that you eat a low-salt, low-fat diet that includes lots of fresh fruits and vegetables and whole grains. Because certain types of exercise can be dangerous for people with cardiomyopathy, talk to your doctor about what type of physical activity is right for you.

    Your doctor is the best source of information on the drug treatment choices available to you.

    If you have a serious heart rhythm disturbance that cannot be corrected with medications, you may need a procedure or a device to help regulate your heartbeat. Some heartbeat abnormalities can be corrected with a controlled shock delivered to the chest, called cardioversion. During cardioversion, special paddles will deliver electrical shocks to your heart to help regulate your heartbeat. Cardioversion is performed under general anesthesia, and may get rid of symptoms and the need for anticoagulants. Sometimes an implanted device that delivers internal shocks is needed. Occasionally a pacemaker will be used to monitor and control heart rhythm.

    If you have hypertrophic cardiomyopathy that is blocking blood flow and you don’t want surgery, you may want to consider a nonsurgical technique called alcohol ablation. This new treatment involves injecting alcohol into a branch of an artery that leads to the heart. The alcohol destroys the excess heart muscle so that there is no need to remove it surgically. People who undergo this procedure may experience chest pain after the injection. In addition, alcohol ablation has been known to disrupt heart rhythm and necessitate a pacemaker. This is a new therapy that is only being done at a few centers around the country; it is still considered to be experimental.

    In some cases of hypertrophic cardiomyopathy, surgery to remove part of the heart muscle (surgical myectomy) may ease discomfort. For this operation, a surgeon will remove the part of your thickened heart that is blocking the blood flow--usually part of the muscular wall that separates the left and right ventricles (septum). At this time, you may need to have the heart valves that connect the heart’s upper and lower left chambers replaced or repaired as well. This eases symptoms in the majority of patients, but results in death in a few. About 5% of patients who undergo surgery will develop a slow heartbeat that needs to be corrected with a pacemaker.

    If you have serious damage to your heart, you may need a heart transplant. If medical treatments have not helped your condition, you may be a candidate for a heart transplant. Most recipients are younger than 60, and are in good health, aside from having a weak heart. In people with advanced disease who have a transplant, 75% of patients live 5 years or longer. Unfortunately, there is a lack of donor hearts, and many people are waiting to receive one.

    Your doctor may give you antibiotics before you have dental work or surgery. This reduces the likelihood that you will develop an infection in the lining of your heart (endocarditis).

    The outlook for people with cardiomyopathy varies.

    Because symptoms usually do not show up until the disease is advanced, many patients become quite sick--although some will improve and remain stable for years.

    • Dilated cardiomyopathy. After being diagnosed with dilated cardiomyopathy, half of patients live for 5 years, and a quarter make it to the 10-year mark.
    • Hypertrophic cardiomyopathy. Approximately 2% of hypertrophic cardiomyopathy patients die suddenly each year from a cardiac arrest. This can often be prevented with insertion of a defibrillator.
    • Restrictive cardiomyopathy. The outlook is the worst for those with restrictive cardiomyopathy because the underlying disease tends to be hard to treat. The exception is when the underlying disease is hemochromatosis, which is treated by removing excess iron from the body. Overall, just 30% of patients are alive within 5 years of being diagnosed. Like dilated cardiomyopathy, this form usually gets worse with time.

    You will need to go for regular checkups so your doctor can monitor your progress and adjust your treatments as needed.

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