Congestive (Dilated) Cardiomyopathy

Congestive cardiomyopathy, also known as dilated cardiomyopathy, is characterized by a weak primary pumping chamber in the heart. Your heart automatically attempts to correct for this inefficiency. In turn, this correction stretches the heart tissue. The dilation can result in a weaker and enlarged heart muscle. This condition also affects other organs such as the liver and lungs. This may ultimately lead to heart failure.

There are many causes of congestive cardiomyopathy. It is often difficult for doctors to pinpoint the origin of this condition. Potential causes may include:

Illnesses

Certain autoimmune disorders such as lupus and rheumatoid arthritis may weaken the heart chambers. Bacterial or viral infections in the body can also affect your heart’s functioning. Similarly, diabetes, thyroid diseases, and late-stage kidney disease may contribute to the stretching of the heart muscle in rare cases.

Drugs

Chronic alcohol or cocaine use can cause dilation of the heart tissue.

Toxins

Exposure to toxic substances such as lead or mercury can contribute to the weakening of the heart.

Medications

Chemotherapy used to treat certain cancers acts as a toxin. This treatment may cause heart problems.

Genetic Conditions

Some genetic disorders are associated with congestive cardiomyopathy. For example, muscular dystrophy is an inherited condition that may weaken the heart. It is also known to impair heart function.

Vitamin and Mineral Deficiencies

Deficiencies in thiamine, magnesium, and calcium can affect heart function.

Other Heart Problems

Coronary artery disease reduces the blood flow to the heart. This, in turn, is a contributing factor in developing this illness. Conditions causing irregular heart rhythms also can contribute to inefficient heart functioning. High blood pressure is a risk factor for heart disease. It can stress the heart and may contribute to this condition.

The risk factors associated with congestive cardiomyopathy vary widely. Lots of factors can increase your risk of developing an enlarged heart chamber. Some of the most common risk factors include:

Age and Sex

Anyone can develop congestive cardiomyopathy, but it is most prevalent among adult males.

Weight

Obesity can increase your risk of developing cardiomyopathy. The extra weight on your body may stress your heart muscle.

Toxins and Drugs

Abusing alcohol and other drugs, such as cocaine, can increase your risk. Undergoing chemotherapy or ingesting toxic quantities of trace elements can also place you at a higher risk.

Heart Problems

A family history of cardiomyopathy raises your risk. Additionally, certain symptoms may increase your chance of developing this illness. These include a previous heart attack, high blood pressure, abnormal heart valve functioning, coronary artery disease, rapid heart rate, and hardening of the arteries. Pregnant women may be at a heightened risk because of the stress pregnancy places on the heart.

Individuals with congestive cardiomyopathy may not show any overt symptoms. It can take months or years for your first symptoms to appear. The first signs of cardiomyopathy often result after a blood clot travels from your heart to another part of the body. Cardiomyopathy eventually causes heart failure.

Heart failure may trigger the following symptoms:

• chest pain
• lack of energy and weakness
• dizziness
• gasping for breath or coughing
• atypical heart rhythm
• swelling of your extremities
• swelling of your abdomen, often caused by liver swelling
• prominent neck veins

In children, a poor appetite that hinders their ability to thrive is a sign of the condition. Children may also exhibit paleness.

Adults may experience frequent urination during the night.

Your doctor will typically start the diagnostic process by taking a medical history, recording your symptoms, and conducting a physical exam. During the exam, your doctor will listen to your heart to determine whether any atypical sounds or rhythms are present. The following tests may be ordered based on the information gathered:

Blood Tests

A series of blood tests can determine if your heart is at risk for this condition. Your blood will be tested to measure the amount of B-type natriuretic peptide (BNP). Increased levels of BNP may indicate heart failure, a common complication of cardiomyopathy. Blood tests can also be used to check your kidney function and whether you have anemia. Blood work can determine if you have hemochromatosis (too much iron). Too much iron can weaken your heart muscle and cause cardiomyopathy. These tests can also help your doctor determine whether you have an infection, autoimmune disease, toxin or thyroid disorder.

Chest X-Ray

This type of X-ray will take a snapshot of your heart and lungs. Your physician will be able to look at the structure of the heart and lungs to determine whether any abnormalities are present.

Stress Test

A stress test involves exercising on a treadmill or other machine. Your doctor will connect electrodes to your chest during this examination. These electrodes monitor and record your heart’s activity with increased stress from exercise.

MRI or CT Scan

An MRI and CT scan are two ways in which your physician can view your heart in detail to check for any anomalies.

Echocardiogram

An echocardiogram uses sound waves to form images of your heart. It will show the movement, structure, and rhythm of your heart.

Electrocardiogram

This test sends electrical currents through your heart to record its activity. This activity will indicate whether abnormal heart rhythms are present.

Heart Catheterization

A heart catheterization is another procedure your doctor may choose for diagnosis. He or she will place a tube into a blood vessel that runs into your heart. This process allows your physician to take pictures of the inside of your heart. It also enables him or her to collect tissue samples from your heart.

Treatment may vary depending on the cause of your cardiomyopathy. If your physician finds that you have blocked arteries, he or she may recommend angioplasty and a stent to enhance blood flow. Angioplasty involves inserting a tiny balloon into your artery and blowing the balloon up to widen the artery. A tiny wire-mesh tube (the stent) may then be inserted to help keep the artery from narrowing. However, most patients need to make lifestyle changes to prevent symptoms from worsening.

Such lifestyle changes include:

• obtaining and maintaining a healthy weight
• eating a low-fat and low-salt diet
• eliminating alcohol

Your physician may start you on medication to lower your blood pressure, eliminate excess fluids, regulate your heart rate, and slow the progression of the condition. The most commonly prescribed medications are:

• angiotensin-converting enzyme (ACE) inhibitors like enalapril (Vasotec), lisinopril (Zestril and Prinivil), ramipril (Altace), and captopril (Capoten).
• angiotensin receptor blockers (ARBs) like losartan (Cozaar) and valsartan (Diovan)
• beta blockers like caredilol (Coreg) and metoprolol (Lopressor and Toprol-XL)
• digoxin (Lanoxin)
• diuretics like Lasix, Bumex, and Aldactone

Other treatment options include implanting a pacemaker to regulate heart rate or using a defibrillator to stop irregular heartbeats. A heart transplant may be the final treatment option for individuals who do not respond to other lines of treatment in severe cases.

Unfortunately, if you have developed this condition because of an inherited condition or genetic mutation, you cannot avoid this condition. However, you can make healthy lifestyle choices to aid in good heart health. This can potentially slow the progression of heart failure.

Such lifestyle choices include:

• not smoking
• eliminating alcohol consumption and drug use
• maintaining a healthy weight
• eating a diet with plenty of fruits, vegetables, and whole grains
• exercising regularly, or as prescribed by your physician