Does cardiomyopathy require surgery?

Written by Liu Yong
Cardiology
Updated on September 17, 2024
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Firstly, whether myocardial disease requires surgery, we need to clarify the type of myocardial disease and the stage of myocardial disease, that is, the stage of heart function that has been affected.

There are many types of myocardial diseases, including dilated cardiomyopathy, ischemic cardiomyopathy, and restrictive cardiomyopathy, for instance. The treatment plans for different types of myocardial diseases are not exactly the same. For example, dilated cardiomyopathy is generally treated with medication, and only in the very late stages of dilated cardiomyopathy, or what is known as stage IV heart function, when conventional medication is ineffective, heart transplantation might be considered if a donor is available and conditions allow. However, currently, heart donors are extremely rare, making this option quite difficult to achieve. The latest advances in clinical research have introduced artificial mechanical hearts available for transplantation, but the costs of surgery are very high, and the technology is not very mature yet. Therefore, the chances and opportunities for surgery are not very great and must be decided based on the situation.

For other conditions, such as ischemic cardiomyopathy, if it is clearly caused by severe ischemia, we might consider addressing the factors causing myocardial ischemia, such as performing a coronary angiography. If there is severe coronary artery stenosis, we might consider implementing a coronary artery stent or coronary artery bypass grafting to alleviate the ischemic factors. In cases like restrictive cardiomyopathy, if there are severe restrictive factors contributing to the disease, surgical treatment might also be pursued.

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Written by Zhang Yue Mei
Cardiology
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What department should I register for cardiomyopathy?

Myocardial disease is a common and frequently occurring disease in clinical practice, caused by various reasons leading to pathological changes in the myocardium. Common causes include viral infections, immune system disorders, and other factors, which can lead to degeneration, necrosis, fibrosis, and interstitial edema of the myocardium. This can cause heart failure, arrhythmias, and in severe cases, even death. Therefore, early diagnosis and timely treatment can save patients' lives and alleviate their suffering. It is necessary to consult with a psychiatrist, undergo relevant examinations under the guidance of a psychiatrist, make a clear diagnosis, and actively treat and rescue the patients.

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Written by Liu Ying
Cardiology
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Can dilated cardiomyopathy be inherited?

We say that dilated cardiomyopathy is a type of cardiomyopathy characterized by enlargement of the left ventricle or both ventricles, accompanied by systolic dysfunction. Some cases of dilated cardiomyopathy are familial, with the main inheritance patterns being autosomal dominant, X-linked recessive, and more rarely, mitochondrial inheritance. The cause of most dilated cardiomyopathies is unclear, but potential causes include infections, non-infectious inflammation, endocrine metabolic disorders, genetics, psychological trauma, and poisoning, including alcohol poisoning. Alcoholism is a common cause of dilated cardiomyopathy in China. Clinically, dilated cardiomyopathy presents with cardiac enlargement, heart failure, arrhythmias, thromboembolism, and sudden death.

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Written by Li Hai Wen
Cardiology
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Clinical manifestations of dilated cardiomyopathy

The clinical manifestations of dilated cardiomyopathy can be summarized in two words: "three hearts," which are reflected in the following three aspects. First, heart enlargement, such as through chest X-rays or echocardiography, often reveals a notable enlargement of the patient's heart. Second, arrhythmias; dilated cardiomyopathy often accompanies a variety of arrhythmias, such as frequent ventricular premature beats, tachycardia, or atrial fibrillation. Third, heart failure. Dilated cardiomyopathy often results in symptoms of heart failure, such as exertional dyspnea and paroxysmal nocturnal dyspnea.

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Written by Tang Li
Cardiology
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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.

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Written by Zhang Yue Mei
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What should patients with cardiomyopathy pay attention to?

Patients with cardiomyopathy need to rest adequately, avoid overexerting themselves, and not get overly emotional to keep their mood calm and prevent an increased burden on the heart, which could trigger heart failure. In their diet, they should consume easily digestible foods that are high in superior protein and eat plenty of fruits and vegetables. These foods can provide the high-quality proteins, vitamins, and trace elements needed by the body, enhancing immunity and disease resistance. In the event of thrombosis and myocardial cell repair, systematic medication treatment under a doctor's guidance is essential to promote myocardial repair.