Cardiomyopathy

Cardiomyopathy

1. Definition Cardiomyopathy refers to diseases of the heart muscle (cardiac muscle) that can lead to the heart failing to pump blood properly. It's a serious condition that can be fatal if not treated.

2. Causes / Etiology Causes of cardiomyopathy can be genetic [inherited], viral infections [e.g. myocarditis], alcohol abuse, exposure to certain toxins [e.g. heavy metals, pesticides], poor diet, lack of physical activity, and certain medical conditions [e.g. diabetes, high blood pressure].

3. Types or Classification There are four main types of cardiomyopathy:

• Dilated Cardiomyopathy (DCM): The heart muscle becomes weak and the heart chambers get larger, making it harder for the heart to pump blood.
• Hypertrophic Cardiomyopathy (HCM): The heart muscle becomes thick, which can block blood flow and make it harder for the heart to pump.
• Restrictive Cardiomyopathy (RCM): The heart muscle becomes stiff, making it harder for the heart to fill with blood.
• Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): The heart muscle in the right ventricle becomes damaged, leading to abnormal heart rhythms.

4. Pathology Step 1: The heart muscle cells become damaged due to various causes. Step 2 → The damaged heart muscle cells lead to inflammation and scarring. Step 3 → The inflammation and scarring cause the heart muscle to become weak and stiff. Step 4 → The weakened and stiff heart muscle makes it harder for the heart to pump blood. Step 5 → The reduced blood flow can lead to heart failure, arrhythmias, and even death.

5. Clinical Features General features:

• Shortness of breath
• Fatigue
• Swelling in the legs and feet
• Chest pain
• Coughing up pink frothy mucus Specific features:
• Dilated cardiomyopathy: Heart failure symptoms, heart murmur, and arrhythmias
• Hypertrophic cardiomyopathy: Heart failure symptoms, heart murmur, and arrhythmias
• Restrictive cardiomyopathy: Shortness of breath, fatigue, and swelling in the legs and feet
• Arrhythmogenic right ventricular cardiomyopathy: Abnormal heart rhythms, heart failure symptoms, and sudden cardiac death

6. Complications Acute complications:

• Heart failure
• Arrhythmias
• Cardiac arrest
• Sudden cardiac death Chronic complications:
• Heart failure
• Arrhythmias
• Cardiac remodeling
• Increased risk of stroke and other cardiovascular diseases

7. Diagnosis / Investigations Routine tests:

• ECG
• Chest X-ray
• Echocardiogram Special tests:
• Cardiac MRI
• Cardiac CT scan
• Cardiac catheterization
• Endomyocardial biopsy

8. Management General management:

• Lifestyle modifications [e.g. diet, exercise, stress management]
• Medications [e.g. diuretics, ACE inhibitors, beta blockers] Modern treatment:
• Implantable cardioverter-defibrillator (ICD)
• Pacemaker
• Heart transplant Dietary advice:
• Healthy diet rich in fruits, vegetables, and whole grains
• Limiting sodium and saturated fat intake
• Staying hydrated

9. Homeopathic Therapeutics

• Aconite: For shock, fear, and anxiety

  • Symptoms worsen at night
  • Heart palpitations and irregular heartbeat
  • Cold sweats and chills

• Digitalis: For heart failure and arrhythmias

  • Symptoms worsen with exertion
  • Shortness of breath and fatigue
  • Swelling in the legs and feet

• Gelsemium: For fatigue, weakness, and lethargy

  • Symptoms worsen with mental or physical exertion
  • Heart palpitations and irregular heartbeat
  • Cold sweats and chills

• Ignatia: For anxiety, stress, and emotional instability

  • Symptoms worsen with emotional stress
  • Heart palpitations and irregular heartbeat
  • Cold sweats and chills

• Lachesis: For heart failure and arrhythmias

  • Symptoms worsen with exertion
  • Shortness of breath and fatigue
  • Swelling in the legs and feet