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Cardiomyopathy
Do you have to take medication for life for dilated cardiomyopathy?
Dilated cardiomyopathy refers to a disease characterized by an enlarged heart, especially significant enlargement of the left ventricle, along with a severe reduction in the heart's ejection fraction. Those diagnosed with dilated cardiomyopathy generally require long-term, and possibly lifelong, medication management. This includes diuretic medications such as furosemide or spironolactone, and β-blocker agents such as metoprolol or bisoprolol. These medications can effectively improve symptoms of heart failure caused by dilated cardiomyopathy, enhance quality of life, and even extend lifespan. Therefore, it is crucial for patients with dilated cardiomyopathy to take medications as prescribed by a doctor and not to discontinue them arbitrarily.
What should be paid attention to in daily life with dilated cardiomyopathy?
For dilated cardiomyopathy, attention should be paid to the following two aspects: First, maintain good living habits, such as a low-salt diet, abstaining from smoking and alcohol, and adhering to appropriate exercise when the condition is stable. At the same time, try to avoid staying up late and excessive fatigue. Second, standardized medication treatment should be carried out under the guidance of a doctor. This includes drugs such as the diuretic furosemide or spironolactone, as well as beta-blockers like metoprolol sustained-release tablets. Proper medication can improve symptoms, reduce the occurrence of heart failure, and lessen hospital visits, thereby improving life quality and extending life span. Never stop or switch any medication on your own at home. (Please consult a doctor before using any medication)
The difference between cardiomyopathy and coronary heart disease
Cardiomyopathy refers to a type of disease characterized primarily by organic changes in the myocardium, such as dilated cardiomyopathy, hypertrophic cardiomyopathy, and restrictive cardiomyopathy. These diseases are characterized mainly by pathological changes in the myocardium itself, forming a category of heart diseases. In contrast, coronary heart disease often refers to a type of heart disease caused by the narrowing of the coronary arteries due to atherosclerosis, leading to insufficient blood supply to the heart. Cardiomyopathy often manifests as damage to the myocardium, while coronary heart disease often manifests as blockage of the blood vessels. This is the fundamental difference between these two categories of heart diseases.
Do you need to take medication for a long time for dilated cardiomyopathy?
Patients with dilated cardiomyopathy need long-term or even lifelong medication because dilated cardiomyopathy is an incurable disease that requires medication to properly control the onset of heart failure symptoms. The symptoms of heart failure due to dilated cardiomyopathy can easily recur, leading to repeated hospitalizations, often related to the patient's irregular medication use or arbitrary discontinuation of medication. Therefore, patients with dilated cardiomyopathy must take medication under a doctor's guidance for long periods, such as using diuretics and medication like sustained-release metoprolol, etc. At the same time, it is important to maintain good living habits, a low-salt diet, a good emotional state, and conduct moderate exercise under stable conditions.
How to recover from decreased physical fitness due to dilated cardiomyopathy?
Dilated cardiomyopathy is diagnosed after excluding conditions such as hyperthyroidism, hypertension, coronary heart disease, cardiac hypertrophy, or myocarditis as underlying causes. Generally, the exact cause of dilated cardiomyopathy is unknown, rendering causal treatment impossible. Once diagnosed with dilated cardiomyopathy, it is impossible to completely cure the condition. The only approach is to manage symptoms and prevent further progression of the disease. Typically, this involves the use of beta-blockers, ACE inhibitors, and diuretics. If the patient has severe cardiac dysfunction, drugs like digoxin, which strengthen heart function, may be considered. If medication does not adequately control the condition, other treatments like CRT might be considered, as well as the use of phosphodiesterase inhibitors, diuretics, or intravenous cardiotonic glycosides.
Is dilated cardiomyopathy more serious or is myocardial ischemia more serious?
This has to be judged comprehensively based on the following conditions: First, the age factor. If it occurs in young people, dilated cardiomyopathy tends to be more severe. This is because dilated cardiomyopathy is an organic heart disease, and myocardial ischemia in young people may not necessarily involve organic heart disease changes, but could also be normal physiological changes in the electrocardiogram. Second, whether there is concurrent cardiac function impairment. Dilated cardiomyopathy definitely involves impairment of the heart's pumping function, whereas myocardial ischemia does not necessarily involve such impairment. Therefore, in most cases, dilated cardiomyopathy is more serious.
What should I do if dilated cardiomyopathy is causing insomnia?
Dilated cardiomyopathy causing insomnia needs to be treated based on the cause of the insomnia. First, if it is simply poor sleep quality causing occasional insomnia, no special treatment is needed. However, if insomnia occurs daily and affects quality of life, sleep-improving medications such as eszopiclone or zopiclone may be taken under a doctor's guidance. Second, if caused by worsening heart failure symptoms, which lead to nocturnal respiratory distress and affect sleep, resulting in insomnia, the treatment for heart failure should be intensified under a doctor's guidance, for instance, by increasing diuretic treatment or adjusting medications. Improving heart failure symptoms naturally enhances sleep quality. (If medication is required, please do so under the guidance of a doctor)
Late-stage symptoms of dilated cardiomyopathy
The so-called advanced stage refers to a phase where cardiac function has reached stage four. The common clinical manifestations of this stage are primarily those of heart failure, such as chest tightness and shortness of breath after activity, inability to lie flat at night, general edema, and even accumulation of fluid in the chest and abdominal cavity. Some patients with severe edema might experience abdominal distension, poor appetite, and even malnutrition, which are all manifestations of heart failure. Once cardiac function reaches stage four, patients with dilated cardiomyopathy are highly susceptible to malignant arrhythmias, such as ventricular tachycardia and ventricular fibrillation. These types of arrhythmias are a common cause of death in the late stages of dilated cardiomyopathy. Therefore, proactive prevention is crucial for these patients as they have a very poor prognosis, and it is essential to maintain active communication with their families.
What is the prognosis of hypertrophic cardiomyopathy?
The prognosis of hypertrophic cardiomyopathy varies greatly, and it is the primary cause of sudden death in adolescents and athletes because it can progress to end-stage heart failure. Additionally, a small percentage may experience heart failure, atrial fibrillation, and embolism, but many patients have mild symptoms and can have a life expectancy close to normal. For the treatment of hypertrophic cardiomyopathy, adequate sudden death risk assessment and ICD prevention should be conducted. Because hypertrophic cardiomyopathy is the most common cause of sudden cardiac death in young people and athletes, an ICD can effectively prevent the occurrence of sudden death. Preventing high-risk factors, including previous cardiac arrest, one or more sudden deaths in first-degree relatives, severe left ventricular hypertrophy, and findings of repetitive non-sustained ventricular tachycardia on a 24-hour Holter monitor, low blood pressure during exercise, and unexplained syncope, especially during exercise, poses a high risk of sudden death in these patients.
Cardiomyopathy is divided into four types.
From a medical perspective, common cardiomyopathies are mainly divided into the following four categories: First, dilated cardiomyopathy, which refers to a type of cardiomyopathy characterized by significant enlargement of the heart, thinning of the ventricular walls, and declined heart function. Second, hypertrophic cardiomyopathy, which refers to a type of cardiomyopathy primarily characterized by thickening of the ventricular walls. Third, arrhythmogenic right ventricular dysplasia, a type of cardiomyopathy that is often clinically associated with episodes of ventricular arrhythmias. Fourth, restrictive cardiomyopathy, which is generally considered rare in clinical practice.