Medically Reviewed by William A. Jackson, MD
Blood system blockages can overwork the heart, leaving it weakened. McLeod Cardiologist William Jackson, MD, explains how that can lead to cardiomyopathy and what treatments are available.
Here are highlights from Dr. Jackson’s comments:
Cardiomyopathy is a weakening of the heart muscle. It can develop into congestive heart failure, meaning the heart has an inability to pump the blood.
Cardiomyopathy comes in many forms. Ischemic cardiomyopathy – related to a blocking of the blood flow — is probably the most common. It is due to heart blockages that have developed over time causing the heart muscle to weaken.
Signs and symptoms of cardiomyopathy generally are fatigue, shortness of breath and fluid retention.
The initial treatment for cardiomyopathy aims to increase the heart muscle strength. The first phase involves medications. We traditionally use beta-blockers, which help slow the heart but overtime will also help strengthen it, in conjunction with another class of drugs called ace inhibitors. We also use diuretics to help remove the extra fluid that the body can’t handle.
If the heart muscle’s not responding to medical therapy, we have other devices, such as pacemakers. You may have heard of a biventricular pacemaker. The revolutionary change that’s happened in the last 15 to 20 years is cardiac resynchronization through a biventricular pacemaker. When we generally put in a simple pacemaker, we put one lead in the right ventricular that causes desynchrony meaning the right ventricular is not beating in sync with the left ventricular. To get around this, we can implant a third lead into the left ventricular and re-establish a normal beat. Cardiac resynchronization improves the symptoms of cardiomyopathy.
Patients who have a delayed EKG are candidates for a biventricular pacemaker. Biventricular pacemakers help the heart resynchronize itself. When you resynchronize the timing of the cardiac cycle, the heart’s strength improves. You are able to treat the cardiomyopathy in conjunction with adequate medical therapy.
Implanting a cardiac defibrillator can be useful in patients, who are at risk for sudden cardiac death. A lot of patients, who have cardiomyopathy are at risk of developing arrhythmias, such as ventricular tachycardia or ventricular fibrillation. When a patient has either of these arrhythmias, they are at risk for sudden cardiac death. An implantable cardiac defibrillator will recognize the potential lethal arrhythmia is starting and deliver an internal shock from inside the heart to break the potential failed arrhythmia.
The goals of treatment when dealing with cardiomyopathy involve compliance with medical care. You also want to avoid a high sodium diet, because sodium makes your body retain fluids. You want to eat healthy, exercise and avoid a sedentary lifestyle.
If it’s ischemic cardiomyopathy, we want to be able to adjust or modify risk factors. Avoid smoking, take care of diabetes, and treat high blood pressure. All of these coupled together with adequate medical therapy will help a patient with a cardiomyopathy heart.