Cardiomyopathy
Cardiomyopathy
is any disease of the heart muscle in which the
heart loses its ability to pump blood effectively.
In some instances, heart rhythm is disturbed and
leads to arrhythmias (irregular heartbeats). There
may be multiple causes of cardiomyopathy, including
viral infections. Sometimes, the exact cause of
the muscle disease is never found.
Cardiomyopathy
differs from many of the other disorders of the
heart in several ways, including the following:
- Cardiomyopathy can,
and often does, occur in the young.
- The condition is fairly
uncommon, affecting only about 50,000 Americans
(adults and children).
- The condition tends
to be progressive and sometimes worsens fairly
quickly.
- It may be associated
with diseases involving other organs, as well
as the heart.
- Cardiomyopathy is a
leading cause for heart transplantation.
Cardiomyopathy
prevents the heart muscle from pumping enough
blood to meet the body's needs.
Viral
infections that infect the heart are a major cause
of cardiomyopathy. In some instances, cardiomyopathy
is a result of another disease or its treatment,
such as complex congenital (present at birth)
heart disease, nutritional deficiencies, uncontrollable,
fast heart rhythms, or certain types of chemotherapy
for childhood cancers. Sometimes, cardiomyopathy
can be linked to a genetic abnormality. Other
times, the cause is unknown. Three types of cardiomyopathy
affect both adults and children.
Dilated
(congestive) cardiomyopathy is the most common
form of cardiomyopathy. The heart muscle is enlarged
and stretched (dilated), causing the heart to
become weak and pump inefficiently. Other problems
that may occur with dilated cardiomyopathy include
the following:
- irregular heart rhythms
- risk of blood clots
- congestive heart failure
Various
infections (including viral) which lead to an
inflammation of the heart muscle (myocarditis)
can cause this type of cardiomyopathy.
Contact
with toxins or very powerful therapeutic drugs,
such as certain types of chemotherapy given to
fight cancer, have been known to cause dilated
cardiomyopathy. Heredity can also be a factor.
Twenty percent of people with dilated cardiomyopathy
have a parent or sibling with the disease. In
many cases, a specific cause for this type of
the disease is never identified.
Because
the heart muscle is weak and unable to pump enough
blood to meet the body's demands, the body tries
to preserve blood flow to essential organs such
as the brain and kidneys by reducing blood flow
to other areas of the body, such as the skin and
muscles.
The
following are the most common symptoms of dilated
cardiomyopathy. However, each child may experience
symptoms differently. Symptoms may include:
- pale or ashen skin
color
- cool, sweaty skin
- rapid heart rate
- rapid breathing rate
- shortness of breath
- fatigue
- irritability
- chest pain
- poor appetite
- slow growth
Specific
treatment for dilated cardiomyopathy will be determined
by your child's physician based on:
- your child's age, overall
health, and medical history
- extent of the disease
- your child's tolerance
for specific medications, procedures, or therapies
- expectations for the
course of the disease
- your opinion or preference
Your
child's physician may recommend medications to
accomplish the following:
- help the heart beat
more effectively
- decrease the workload
of the heart
- decrease the oxygen
requirements of the heart
- prevent clots from
forming
- decrease inflammation
of the heart
- regulate irregular
heartbeats
In some
cases, dilated cardiomyopathy due to viral causes
improves. In other cases, the condition worsens
and transplantation of the heart may be considered.
Consult your child's physician for more information
regarding the specific outlook for your child.
In hypertrophic
cardiomyopathy, the muscle mass of the left ventricle
of the heart is larger than normal, or the wall
between the two ventricles (septum) becomes enlarged.
These abnormalities obstruct the blood flow from
the left ventricle.
The
thickened muscle or septal wall can also affect
one of the leaflets of the mitral valve, which
separates the left atrium and the left ventricle.
The valve leaflet becomes leaky, allowing blood
to move backwards from the left ventricle into
the left atrium, instead of forward to the body.
Hypertrophic
cardiomyopathy is often hereditary. One-half of
children with the disease have a parent or sibling
with varying degrees of left ventricular muscle
or ventricular wall enlargement, although relatives
may or may not have symptoms.
Children
with hypertrophic cardiomyopathy may have symptoms
that increase with exertion or symptoms may be
unpredictable.
The
following are the most common symptoms of hypertrophic
cardiomyopathy. However, each child may experience
symptoms differently. Symptoms may include:
- shortness of breath
on exertion
- dizziness
- fainting
- chest pain
- abnormal heart rhythms
Specific
treatment for hypertrophic cardiomyopathy will
be determined by your child's physician based
on:
- your child's age, overall
health, and medical history
- extent of the disease
- your child's tolerance
for specific medications, procedures, or therapies
- expectations for the
course of the disease
- your opinion or preference
Your
child's physician may recommend medications to
accomplish the following:
- decrease the workload
of the heart
- decrease the oxygen
requirements of the heart
- regulate irregular
heartbeats
Surgical
treatment may include:
- removal of part of
the enlarged muscle
- artificial pacemaker
- heart transplantation
Consult
your child's physician for more information regarding
the specific outlook for your child.
Restrictive
cardiomyopathy, the least common type of cardiomyopathy
in the US, occurs when the myocardium of the ventricles
becomes excessively rigid, and the filling of
the ventricles with blood between heart beats
is impaired. This condition occurs rarely in children.
Restrictive
cardiomyopathy usually results from another disease,
which occurs elsewhere in the body. However, there
are idiopathic (cause unknown) occurrences as
well. Restrictive cardiomyopathy does not appear
to be inherited, but some of the diseases that
lead to the condition are genetically transmitted.
Conditions
that may be associated with the development of
restrictive cardiomyopathy include, but are not
limited to, the following:
- scleroderma (a chronic,
degenerative disease that affects the joints,
skin, and internal organs)
- amyloidosis (a rare
disease which causes the buildup of amyloid,
a protein and starch, in tissues and organs)
- sarcoidosis (a rare
inflammation of the lymph nodes and other tissues
throughout the body)
- mucopolysaccharidosis
(a condition in which mucopolysaccharides, or
carbohydrates that bond with water to form a
thick, jelly-like substance, accumulate in body
organs)
- cancer
Radiation
therapy for cancer treatment has also been associated
with restrictive cardiomyopathy.
The
following are the most common symptoms of restrictive
cardiomyopathy. However, each child may experience
symptoms differently. Symptoms may include:
- shortness of breath
on exertion
- chest pain
- weakness
- swelling of the extremities
Specific
treatment for restrictive cardiomyopathy will
be determined by your child's physician based
on:
- your child's age, overall
health, and medical history
- extent of the disease
- your child's tolerance
for specific medications, procedures, or therapies
- expectations for the
course of the disease
- your opinion or preference
Your
child's physician may recommend medications to
accomplish the following:
- decrease the workload
of the heart
- decrease the oxygen
requirements of the heart
- prevent blood clots
from forming
- regulate irregular
heartbeats
Surgical
treatment may include:
- removal of part of
the enlarged muscle
- artificial pacemaker
insertion
- heart transplantation
Consult
your child's physician for more information regarding
the specific outlook for your child.
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