CAD 1217

• Cardiomyopathy


  Also called heart muscle disease. An acquired or hereditary disease of the heart muscle, this condition makes it hard for the heart to deliver blood to the body and can lead to heart failure.
• Etiology of cardiomyopathy


  • Viral infection in the heart
  • Connective tissue disease and other types of autoimmune disease
  • Other treatments like chemotherapy
• Predisposing factors for cardiomyopathy

  • Long term high blood pressure
  • Heart tissue damage from heart attack
  • Long term rapid heart rate
  • Heart valve problem or disease
  • COVID 19 infections
  • Certain infections especially that can cause inflammation of the heart
  • Metabolic disorder e.g. obesity , thyroid disease or diabetes
  • Lack of essential vitamins or minerals in the diet such as vitamin B1
  • Iron buildup on the heart muscle (hemochromatosis)
  • Drinking too much alcohol over many years and use of caffeine
  • Build up of proteins in the organs
  • Use of chemotherapy drugs and radiations to treat cancers
• Types of cardiomyopathies


  • Hypertrophic cardiomyopathy
  • Dilated cardiomyopathy
  • Arrhythmogenic cardiomyopathy
  • Restrictive cardiomyopathy
  • Unclassified cardiomyopathy
• Hypertrophic cardiomyopathy


  • Heart muscle becomes larger and thicker than normal
  • The thickened areas can block the ventricles (lower chambers of the heart) making it hard for the heart to pump blood
  • Mostly affects the left ventricle
  • Usually genetic, but can also be acquired due to high blood pressure, diabetes or thyroid disease
• Dilated cardiomyopathy


  • The heart main pumping chamber (the left ventricle) becomes enlarged (dilated),weak and can't effectively pump blood out of the heart
  • It happens in middle aged people and more likely men
  • It is the main cause of the coronary heart disease
  • Other causes include inheritance, infections, inheritance or alcoholism
• Arrhythmogenic cardiomyopathy


  • Also known as Arrhythmogenic Right Ventricular Dysplasia (ARVD)
  • It develops when the fatty tissue or the scared tissue replaces the normal tissues of the right ventricles causing an irregular heart beat(arrhythmias)
  • It mostly affect teens or young adults, also raises the risk of cardiac arrest
• Restrictive cardiomyopathy


  • The heart muscles becomes stiff and less flexible thus can't expand to refill the heart with blood
  • It is the least common type of cardiomyopathy can occur at any age but mostly affect the older people
  • Causes include heart disease, scarring of the heart or certain disorders that affect the heart
• Signs and symptoms of cardiomyopathy


  • Chest pain (Angina)
  • Dizziness
  • Abnormal heart rhythm
  • Fatigue
  • Heart murmurs
  • Bloating of fluid in the abdomen
  • Peripheral edema
  • Shortness of breath
  • Swelling of the legs, ankles & feet
• Risk factors for cardiomyopathy

  • Family history
  • Coronary artery disease
  • Diabetes
  • Obesity
  • Excessive alcoholism
• Pathophysiology of cardiomyopathy


  1. Blood flow is stagnant or slow in an area in the chamber of dilated heart

  2. Ventricle ability to pump blood reduces significantly

  3. Due to inflammation etiological factors

  4. Inflammation and rapid degeneration of myocardial fiber
• Diagnostic tests for cardiomyopathy

  • Chest x-ray
  • Echocardiogram
  • Electrocardiogram
  • Blood test
  • Genetic testing or screening
  • Cardiac CT scan
  • Cardiac catheterization
• Medical management of dilated cardiomyopathy

  1. Angiotensin-converting enzyme (ACE) inhibitors e.g. Enalapril (Vasotec), benazepril

  2. Angiotensin II receptor blockers (ARBs) e.g. Losartan, Telmisartan

  3. Beta blockers e.g. Bisoprolol, Atenolol

  4. Aldosterone antagonists e.g. Eplerenone

  5. Diuretics e.g. Lasix (furosemide)

  6. Cardiac glycosides

  7. Nitrates e.g. nitroglycerin

  8. Vasodilators E.g. hydralazine
• Surgical options for dilated cardiomyopathy

  1. Left ventricular assist devices

  2. Ventricular restoration surgery

  3. Heart transplant

  4. Automatic implantable cardioverter-defibrillators
• Complications of cardiomyopathy


  • Heart failure
  • Clots formation
  • Valve problems
  • Cardiac arrest
  • Sudden death
• Prevention measures for cardiomyopathy

  • Stop alcohol and cocaine consumption
  • Control blood pressure, diabetes and cholesterol levels
  • Eating healthy diet
  • Regular exercise
  • Enough sleep
  • Avoid/reduce stress