Cardiomyopathy

Cardiomyopathy is a progressive disease of the myocardium, the heart muscle. The condition is either confined to the heart or is part of generalised systemic disorders. They often lead to cardiovascular death or progressive heart failure-related disability.

These diseases have many causes, signs and symptoms and treatments. The heart muscle either becomes enlarged, thick or rigid in cardiomyopathy. In rare cases, the muscle tissue is replaced with a scar tissue.

The main types of cardiomyopathy are dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy and arrhythmogenic right ventricular dysplasia.

Some other types of cardiomyopathy are called ‘unclassified cardiomyopathy’ and ‘stress-induced cardiomyopathy’, also known as broken heart syndrome.

Cardiomyopathy can be inherited i.e. a family history of cardiomyopathy, sudden cardiac arrest, or heart failure. Four in ten cardiomyopathies – a major cause of sudden cardiac death and heart failure in young people – are genetic, according to a study published today.

Often, the cause isn’t known and it can affect all ages and certain age groups are more likely to have certain types of cardiomyopathy, according to a Consultant Interventional Cardiologist.
  
Symptoms
People with cardiomyopathy never have signs or symptoms in the early stages of the disease. It usually occurs later as the heart weakens.

“The cardiac expression of these genetic diseases starts early in some patients,” said the first author of the study. “In others it is delayed for many decades – longer than previously thought.”

Symptoms such as – shortness of breath, fatigue, and light-headedness or dizziness, edema or swelling in the ankles, feet, legs, abdomen, and veins in the neck, fainting attacks during physical activity, arrhythmias (irregular heartbeats), chest pain, especially after physical exertion or heavy meals.

Medication
People with cardiomyopathy condition are prescribed medicines such as ACE inhibitors, angiotensin II receptor blockers, beta blockers, and calcium channel blockers to lower the blood pressure. Beta blockers, calcium channel blockers, and digoxin help in decreasing the heart rate.

An antiarrhythmic drug helps to keep the heart beating with a normal rhythm. Diuretics are used to remove excess fluid and sodium from the body. Anticoagulants – “blood thinners” helps to prevent blood clots. Blood thinners are often used to prevent blood clots from forming in people who have dilated cardiomyopathy.

Treatment
With proper lifestyle modification, one can lower the risk for diseases or conditions that may lead to or complicate cardiomyopathy. A healthy diet and physical activities are part of a healthy lifestyle. A healthy diet includes a variety of fruits, vegetables, and grains.
It is suggested to consume foods that are low in saturated fat, trans fat, and cholesterol. Salt intake should be reduced. Smoking and consumption of alcohol and illegal drugs should be avoided. Having a good sleep and rest will help in reducing stress.
It is also important to note that one should take proper measures to treat conditions such as diabetes and high blood pressure.

Treatment
People with cardiomyopathy should get medical advice before performing any kind of physical activities. Implanted devices mentioned below helps the heart work better. The goal of treatment is to help your heart be as efficient as possible and to prevent further damage and loss of function.

Pacemaker, a small device that’s placed under the skin helps to control arrhythmias. It uses electrical pulses to prompt the heart to beat at a normal rate.

Cardiac resynchronization therapy (CRT) device coordinates contractions between the heart’s left and right ventricles.

A left ventricular assist device (LVAD) helps the heart pump blood to the body. An LVAD can be used as a long-term therapy or as a short-term treatment for people who are waiting for a heart transplant.

An implantable cardioverter defibrillator (ICD) helps control life-threatening arrhythmias that may lead to a sudden cardiac arrest.

This small device is implanted in the chest or abdomen and connected to the heart with wires. If an ICD senses a dangerous change in heart rhythm, it will send an electric shock to the heart to restore a normal heartbeat.

Heart Transplant is considered as a last resort treatment for people whose condition has become so severe that all treatments have failed. 

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Menopausal women experience an accelerated decline in lung function

Women suffer an increased decline in lung function during menopause, claims a recent research.

“Women are living longer and, therefore, many years beyond menopause,” said Kai Triebner, MSc, lead author of the study, which was published in the American Journal of Respiratory and Critical Care Medicine.

”Our study highlights the importance of maintaining respiratory health long after the menopausal transition,” Triebner added.
The researchers report that both forced vital capacity (FVC), a measure of lung size, and forced expiratory volume in one second (FEV1), a measure of how much air can be forcefully exhaled in one second, declined in women going through the menopausal transition and after menopause beyond what would be expected through normal aging.

The authors wrote that the decline in FVC was comparable to smoking 20 cigarettes a day for 10 years, and the decline in FEV1 was comparable to smoking 20 cigarettes a day for two years.
The more pronounced decline in FVC than FEV1 indicated menopause was more likely to cause restrictive, rather than obstructive, breathing problems.

Obstructive breathing problems (including COPD) make it difficult to exhale air from the lungs while restrictive breathing problems (including sarcoidosis) make it difficult to fully expand the lungs upon inhaling.

“Whether obstructive or restrictive, the decline in lung function may cause an increase in shortness of breath, reduced work capacity and fatigue,” Triebner said.

Adding, “Symptoms depend upon how much lung capacity is reduced, and a few women may actually develop respiratory failure as a result of this decline.”

In what they believe is the first longitudinal population-based study of lung function and menopause, the researchers analysed data from 1,438 women enrolled in the European Respiratory Health Survey.
Participants in the study ranged in age from 25 to 48 at enrolment, and none was menopausal when the study began.

They were followed for 20 years and during that time most went through the menopausal transition or became postmenopausal.

The researchers adjusted their findings for age, weight, height, education and smoking history.

As might be expected, current and past smokers showed a steeper decline in both age — and menopause-related lung function decline.
The authors said there were several possible explanations for their findings.

Menopause brings hormonal changes that have been linked to systemic inflammation, which itself is associated with lung function decline.

Hormonal changes are also implicated in osteoporosis, which shortens the height of the chest vertebrae and may, in turn, limit the amount of air a person can inhale.

“Women, and their physicians, should be aware that respiratory health might decline considerably during and after the menopausal transition,” Triebner said.

Adding, “This could mean that they experience shortness of breath already with low physical activity.” 

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