Description cardiomyopathy
Cardiomyopathy refers to heart muscle disease, in which the damaged heart pumps blood inefficiently. The disease usually progresses to the point, when patients ill with life-threatening heart failure. Besides, у людей с кардиомиопатией большая вероятность возникновения нерегулярного сердцебиения или аритмии.
There are two main types of cardiomyopathy: ishemicheskaya and neishemicheskaya cardiomyopathy.
Ishemicheskaya cardiomyopathy found, когда сердечная мышца повреждена от сердечного приступа из-за заболевания коронарной артерии.
Neishemicheskaya cardiomyopathy It includes types of cardiomyopathy, are not associated with coronary artery disease.
There are three main types of non-ischemic cardiomyopathy:
- Дилатационная кардиомиопатия – повреждение сердечной мышцы приводит к уменьшению функционирующих кардиомиоцитов совместно с увеличением камер и повышенной эластичности сердца;
- Гипертрофическая кардиомиопатия – патологическое разрастание волокон сердечной мышцы. The heart wall thickens, reducing the space in the chambers of the heart. Since the heart between beats almost relaxes, pumped by a very small amount of blood;
- Рестриктивная кардиомиопатия – некоторые области сердечной стенки становятся твердыми и теряют эластичность. Hardness often occurs due to abnormal tissue, invading the heart muscle.
Causes of cardiomyopathy
In many cases, the exact cause is not known. Possible causes:
Dilatatsionnaya cardiomyopathy
The reasons for the initial damage is often not found, but may include:
- Ischemic heart disease with reduced blood flow to the heart;
- Infection, usually, Viral;
- Chronic exposure to toxins, в том числе алкоголя и некоторых химиотерапевтических препаратов;
- A rare complication of pregnancy and childbirth (perhaps, immune related);
- Редко – другие заболевания, including rheumatoid arthritis, diabetes or thyroid disease.
Gipertroficheskaya cardiomyopathy
The reasons may be:
- Heredity (sometimes present at birth, but it often develops in adolescents);
- Aging, associated with hypertension.
Restriktivnaya cardiomyopathy
The reason is usually associated with the presence of other diseases, such as:
- Амилоидоз – накопление белковых волокон в сердечной мышце;
- Саркоидоз – возникновение небольшой воспалительный массы (granulomas) in many organs;
- Гемохроматоз – накопление большого количества железа в организме.
Risk factors for cardiomyopathy
Factors, which increase the risk of cardiomyopathy:
- The presence of family members with cardiomyopathy;
- Alcoholism;
- Obesity;
- diabetes;
- Hypertension;
- Coronary artery disease;
- Taking certain medications.
Symptoms of cardiomyopathy
Symptoms vary, depending on the type of cardiomyopathy and its severity.
Patients with hypertrophic cardiomyopathy often do not notice any symptoms. Sudden cardiac death may be the first sign of disease.
With the development of dilated cardiomyopathy symptoms may last for years. Because of the abnormal accumulation of blood in the heart can be formed thrombi. If the clot travels to another part of the body (embolism), symptoms, associated with that body (eg, brain) may be the first sign of heart disease.
Cardiomyopathy ultimately leads to heart failure and the following symptoms:
- Fatigue;
- Weakness;
- Breathlessness, often deteriorated while in a lying position or excessive physical activity;
- Cough;
- Swelling of the legs or feet;
- Chest pain;
- Cardiac arrhythmias.
Diagnosis of cardiomyopathy
The doctor will ask about your symptoms and medical history. Examine physically. The doctor listens to the heart with a stethoscope. Cardiomyopathies often produce noise and other unusual sounds in the heart.
Tests may include:
- Рентген грудной клетки – тест, which uses X-rays, to photograph the structures inside the thorax. Used to find expansion of the heart.
- ЭКГ – тест, which detects heart activity by measurement of electrical current through the heart muscle;
- Эхокардиограмма – тест, which uses high-frequency sound waves (ultrasound), to examine the size, shape and motion of the heart;
- Blood tests, to ensure damage to the heart and other organs, and, perhaps, reason (s) kardiomiopatii
- Катетеризация сердца – специальный инструмент вводится в сердце через вену или артерию (usually in the arm or leg), to detect problems with the heart and its blood supply;
- Биопсия сердца – удаление образца ткани сердца для тестирования.
Treatment of Cardiomyopathy
In heart failure due to blockages in the coronary arteries, treatment, направленное на их снятие путем ангиопластики
,
стентирования или аортокоронарного шунтирования может привести к улучшению сердечной функции и уменьшению симптомов болезни. If cardiomyopathy is caused by genetic causes, to improve heart function can lead other treatments. For many patients, However, treatment is aimed at relieving symptoms and preventing further damage.
Lifestyle changes
The changes are aimed at removing all, that contributes to disease or deterioration of symptoms:
- Avoid alcohol;
- If you are overweight, Try to lose weight;
- Go to high fat diet, to minimize the risk of coronary heart disease;
- Need to limit salt intake to reduce fluid retention;
- Follow the advice of your doctor. Maybe, you have to restrict physical activity.
Medication
Medications may include:
- Diuretics, to remove excess fluid;
- ACE inhibitors, to help relax the blood vessels, lower blood pressure and reduce the load on the heart;
- Hydralazine and Isosorbide dinitrate, that can be used in addition to the IAPF;
- Блокаторы рецепторов ангиотензина – действие подобно ингибиторам АПФ;
- Препараты наперстянки, to slow and regulate the heart rate, and slightly increase the force reductions;
- Beta Blockers, to slow the disease progression;
- Спиронолактон – улучшает состояние пациентов с дилатационной кардиомиопатией и начальными симптомами.
Operation with cardiomyopathy
Surgical options include:
- Кардиостимулятор – может быть имплантирован, to stabilize the heart rate;
- Для людей с гипертрофической формой болезни – врач может удалить часть утолщенной стенки, separating the Chambers of the heart. Операция может быть необходима для замены сердечного клапана. Another option is called alcoholic septal′naâ ablation. This procedure helps to reduce symptoms and improve the functioning of the heart;
- For those patients who have irregular heart rhythm threatens life, perhaps, нужно имплантировать дефибриллятор-кардиовертер;
- Пересадка сердца может быть возможным вариантом для здоровых пациентов, If other methods have proven ineffective. Candidates often have to wait long for a new donor heart. На период ожидания может быть временно установлен искусственный желудочек сердца – механический насос, that assumes some or most of the pumping heart function.
Prevention of cardiomyopathy
Aggressive treatment of hypertension, Ischemic disease of the arteries and their risk factors is the best way to prevent most cases of cardiomyopathy.
Other, less common causes, cure is often impossible. People with a family history of the disease should consult a doctor to undergo screening tests, especially before the beginning of the intensive physical loads.