Cardiomyopathy is divided into four types.

Written by Li Hai Wen
Cardiology
Updated on September 27, 2024
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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.

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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 Liu Yong
Cardiology
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Does cardiomyopathy require surgery?

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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Can people with cardiomyopathy run?

Whether a person with myocardial disease can run or not depends on the extent of myocardial damage and clinical symptoms. If the myocardial damage is severe and there are significant clinical symptoms of heart failure and arrhythmia, this group should not run and needs bed rest. If strenuous activity would worsen heart failure, the myocardial damage is mild, with no typical clinical symptoms, and does not affect daily activities, this group can engage in appropriate exercises like walking or running, but the duration should not be too long, about 20 to 30 minutes each time.

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Written by Xie Zhi Hong
Cardiology
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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.