What should I do if dilated cardiomyopathy is causing insomnia?

Written by Li Hai Wen
Cardiology
Updated on October 22, 2024
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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)

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Written by Li Hai Wen
Cardiology
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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.

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Written by Liu Yong
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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Written by Li Hai Wen
Cardiology
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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.

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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 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.