"Cardiomyopathy" is a generalized diagnosis, which is made in the case of such pathologies of the heart muscle, the causes of which could not be established. If during the examination congenital anomalies or heart defects were not confirmed, as well as changes that appeared as a result of vascular diseases and pathologies of the conduction system, then the above diagnosis is the only true one.
Cardiomyopathy: causes of pathology
Doctors say that cardiomyopathy can be both idiopathic (i.e., primary), and secondary. In the first case, as mentioned above, the causes of the disease are definitely impossible to name.
In the second case, the diagnosis is usually associated with some predetermining factors:
- it may be a genetic predisposition (in the family there are patients with this diagnosis or suddenly died at a young age);
- disruption of the immune system;
- transferred viral diseases;
- alcoholic, drug or other intoxication causing myocardial damage;
- endocrine diseases;
- persistent arrhythmia;
- pathology of connective tissue.
By the way, the hereditary form of the disease is about 25% of all cases of this pathology and, unfortunately, has the most unpredictable outcome.
How does cardiomyopathy develop
Most often, the development of the disease takes place according to one scheme. As a result of any inflammatory processes in the heart muscle, cells affected by the virus begin to die. They become dangerous to the human body, and the immune system thus gets rid of them. In place of dead cells, connective tissue appears, which does not have the properties inherent in the myocardium. It is less elastic, stretches worse, there is practically no contractile activity in it.
In this case, to cope with the function of the pump, which is entrusted to the heart, its chambers begin to expand, sometimes increasing several times. And in order to deliver oxygen to all organs and tissues, it begins to work on wear, teaching rhythm. This is how cardiomyopathy develops. Unfortunately, death from severe arrhythmia in advanced cases is not a rare occurrence.
Why does cardiomyopathy occur in childhood
As in adults, in children cardiomyopathy can be congenital and acquired. In the latter case, it develops during the growth of the child and is most often caused by a violation of the formation of heart muscle cells.
Cardiomyopathy in infants and young children, as a rule, has uncharacteristic signs of the course. They usually do not depend on what type of the disease is, and sometimes begin to appear in newborns in the form of severe circulatory failure. And in older children, cardiomyopathy can occur without any symptoms and accidentally show up on an ECG or during an x-ray of the chest.
Types of Cardiomyopathy: Dilatation Type of Disease
The WHO included the diagnosis of cardiomyopathy (ICD - 10) in the group of diseases of the circulatory system, highlighting the three main types of primary damage to the heart muscle. This is dilated (or congestive), hypertrophic and restrictive cardiomyopathy. They are distinguished based on the degree of damage to the ventricles and the state of intracardiac circulation.
Congestive cardiomyopathy is characterized by a pronounced expansion of the heart chambers and an uneven thickening of their walls against the background of a decrease in myocardial contractility. By the way, in most cases, this pathology is a hereditary disease.
Unfortunately, the prognosis of the course of the described disease is very serious. With the diagnosis of dilated cardiomyopathy, death may occur already in the first 5 years of the disease, although with sufficient drug therapy, the patient's life can be significantly extended.
Hypertrophic cardiomyopathy
The hypertrophic form of the disease is often found in young men who die during sports. This is due to a violation of the rhythm of contractions of the heart muscle, which causes a significant increase in the wall thickness of the left ventricle, and no expansion of its cavity is observed.
Symptoms of this form of cardiomyopathy are easily determined, expressed in pain behind the sternum, shortness of breath and increased heartbeat. At the same time, patients may suffer from causeless fainting, which most often occurs during stressful situations or during physical exertion.
Hypertrophic cardiomyopathy is both a congenital and an acquired pathology. It is difficult to detect with radiology, since the outwardly cardiac contour does not change, and the internal shape of the ventricular cavity is viewed only with the help of ultrasound.
Restrictive Cardiomyopathy
The most rare type of primary cardiomyopathy is its restrictive form. With this pathology, there is a violation of the contractile function of the myocardium, accompanied by a decrease in relaxation of the walls of the heart muscle. Filling of the left ventricle with blood suffers from this, but thickening, as in the previous case, is not observed. But atria, experiencing an increased load, suffer greatly.
Restrictive cardiomyopathy is a disease that can manifest itself both as an independent pathology and as a component of other heart ailments.
The features of this type of disease are the delayed manifestation of symptoms and the associated difficulties in identifying problems in the early stages. As a rule, obvious signs of pathology are found already in the thermal period, when heart failure joins the disease, which leads to a high mortality rate.
Causes of dishormonal cardiomyopathy
In addition to the above, there are several types of secondary cardiomyopathy that occurs against the background of a systemic disease.
So, dishormonal cardiomyopathy is a clinical syndrome characterized by a pathology of the heart that has arisen under the influence of hormonal disruptions.
Against the background of a lack of sex hormones in the patient, myocardial damage occurs, which is non-inflammatory. The basis of this lesion is, as a rule, dysfunction of the ovaries in women of menopause or diseases of the endocrine system.
Features of the manifestation of dishormonal cardiomyopathy
Dyshormonal cardiomyopathy manifests itself, mainly with burning, stitching or pulling pains in the region of the heart (the so-called cardialgia). In patients with this, pain is radiating to the left arm, shoulder blade and even to the lower jaw, and such an attack can last several hours or several days. With this type of cardiomyopathy, patients most often complain of palpitations, a feeling of lack of air and dizziness. They also exhibit manifestations of fluctuations in blood pressure and general neurotization (increased irritability, irritability, tearfulness, memory loss).
It should be noted that the deterioration of the patient’s condition is, as a rule, not associated with physical or emotional stress, and taking nitroglycerin does not bring relief.
In addition to the above, there is another feature of the manifestation of the dishormonal form of the described pathology - a feeling of unbearable heat in the region of the upper chest, neck and face, accompanied by severe sweating.
What happens with dysmetabolic cardiomyopathy
Dysmetabolic cardiomyopathy is a secondary disease that is associated with impaired tissue metabolism. In this case, not only the heart is affected, but also other organs. By the way, those parts of the heart muscle where most of the blood vessels are located are most affected.
Due to progressive endotoxemia, the cells that underlie the tissues of this organ undergo irreversible changes. They lead to myocardial dystrophy and impaired heart function. By the way, protein and fat products of other organs have the most negative effect on the muscle.
Symptoms of dysmetabolic cardiomyopathy
Most often, dysmetabolic cardiomyopathy does not manifest itself for a long time. Only with a targeted examination of the cardiovascular system are possible to detect ECG changes. But over time, an increase in symptoms occurs.
As a rule, patients begin to complain of heaviness and a feeling of constriction in the sternum, rapid heartbeat, asthma attacks. Moreover, if at first these complaints arise only after physical exertion, then subsequently this clinical picture is also observed at rest.
As the pathology progresses, edema on the legs appears in the patients, the stomach grows and the pain in the liver bothers.
Stagnation in the pulmonary circulation causes breathing problems. The patient experiences severe shortness of breath. A stagnation in a large circle entails the defeat of other organs. Cardiac output is reduced. Since the heart does not cope with the load, and this is accompanied by a rhythm disorder and a decrease in the filling of the pulse.
How to detect cardiomyopathy in the early stages
In all cases of the described pathology, heart failure becomes a companion of the diagnosis of cardiomyopathy. The cause of death from this disease, as a rule, is closely dependent on the timely detection and correct diagnosis of the pathology. Therefore, it is very important to contact specialists if there are any suspicions of heart problems, especially if there are relatives in the family with this ailment.
Diagnosis is usually made by exclusion. The specialist should conduct a thorough examination of the patient and listen to the heart sounds, as some pathologies can be recognized by their frequency and the number of noises. To further clarify the diagnosis, a biochemical blood test is performed. At the same time, they do not forget about the condition of the liver and kidneys. Why urine is examined and a general clinical blood test is done.
As you probably already understood, cardiomyopathy is a disease that is quite difficult to diagnose, therefore, all patients with suspicion of it undergo heart ultrasound , echocardiography, MRI and CT, as well as daily ECG monitoring.