What causes cardiomyopathy?

Written by Zhang Yue Mei
Cardiology
Updated on September 24, 2024
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In clinical practice, the most common type of myocarditis is viral myocarditis. Due to a decrease in the body's resistance, the virus invades and damages the myocardium, causing localized and diffuse inflammatory damage to the heart muscle, which poses significant harm to the body. The early clinical symptoms of viral myocarditis often manifest primarily as respiratory and gastrointestinal symptoms, accompanied by palpitations and shortness of breath, necessitating the use of electrocardiograms and myocardial enzyme spectrum tests. Early detection, diagnosis, and treatment of viral myocarditis play a crucial role in the prognosis.

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What should be noted for dilated cardiomyopathy?

Patients with dilated cardiomyopathy should actively look for the cause of the disease and provide corresponding treatments, such as controlling infections, strictly limiting or abstaining from alcohol, treating relevant endocrine or autoimmune diseases, correcting electrolyte disorders, and improving nutritional imbalances, etc. In the early stages of dilated cardiomyopathy, although there is already enlargement of the heart and impairment of contractile function, there are no clinical manifestations of heart failure. At this stage, early pharmacological intervention should be actively implemented to slow down ventricular remodeling and further damage to the myocardium, delaying the progression of the disease. As the condition progresses, the patient's ventricular contractile function further decreases and clinical manifestations of heart failure appear. At this point, treatment should follow the guidelines for chronic heart failure. However, the specifics of the treatment and the choice of medication should be determined by a specialist based on the patient’s condition.

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Dilated cardiomyopathy clinical manifestations

Dilated cardiomyopathy is a type of heart disease characterized clinically by a significant enlargement of the heart, a marked reduction in ejection fraction, and a significant decline in heart function. Common clinical manifestations of this disease often present as heart failure symptoms, including chest tightness and shortness of breath after activity, nocturnal paroxysmal breathing difficulties, inability to lie flat, as well as swelling of the lower limbs and abdominal wall, and even conditions such as pleural effusion and ascites. Additionally, it may be associated with various types of arrhythmias, such as premature beats and tachycardia, especially ventricular tachycardia, which are all manifestations of dilated cardiomyopathy.

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Cardiology
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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.

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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.

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Treatment of Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, due to unknown causes and often related to genetic factors, is difficult to prevent. It is important to guide patients on how to lead their lives, reminding them to avoid intense physical activities, heavy lifting, or breath-holding to reduce the incidence of sudden death. Avoid using drugs that enhance myocardial contractility and reduce cardiac capacity load, such as digoxin and nitrates, to decrease the aggravation of left ventricular outflow tract obstruction. The treatment principle for this disease is to slow down the hypertrophy of the myocardium, prevent tachycardia, and maintain normal sinus rhythm. It also aims to relieve the narrowing of the left ventricular outflow tract and counteract arrhythmias. Currently, the use of beta blockers and calcium channel blockers is advocated. For severe obstructive patients, interventional and surgical treatments can be carried out, including the implantation of a dual-chamber DTD pacemaker, and the ablation or removal of hypertrophied interventricular septum myocardium.