Cardiomyopathy is a disorder of the heart muscle that causes the heart to lose its ability to pump blood efficiently. Along with it, the heart rhythm can also be disturbed, leading to arrhythmias (irregular heartbeats).

There are multiple causes of cardiomyopathy, like alcohol and or tobacco use, high blood pressure, uncontrolled and or long-standing diabetes mellitus, coronary artery disease, and viral infections. The recent Covid-19 virus has been found to cause heart problems in survivors over time.

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It may be associated with diseases like hyperthyroidism, rheumatoid arthritis, etc. Certain medicines like painkillers, some drugs used in diabetes, and hypertension, can cause cardiomyopathy over time. At times the precise cause may not be found. Genetic factors are also implicated. Therefore, if there is a close blood relative suffering from it, there is a high risk of the individual being affected.

Cardiomyopathy can occur in middle-aged, as well as young people. It tends to be progressive. Types of cardiomyopathy that typically affect adults are:

Hypertrophic cardiomyopathy; where the heart muscle becomes thickened, hence impeding the effective forward flow of blood as desired. In dilated cardiomyopathy, the heart muscle becomes slack and, therefore, does not remain as efficient as before in pumping blood forward in the body.

In restrictive cardiomyopathy; the heart chambers become stiff over time. The contraction remains effective, but the heart muscle is unable to relax properly. This also affects the forward flow of blood in the body. Each type of cardiomyopathy ultimately leads to cardiac failure over time.

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This condition is easily suspected by clinical features. Shortness of breath or breathlessness is the earliest feature, which usually alerts one to the possibility of cardiomyopathy. Initially, breathlessness occurs on moderate to severe exertion, but gradually one gets breathless even on slight exertion or resting.

As the functioning of the heart muscle becomes weak, oxygen delivery to various tissues is reduced, resulting in early fatigue. There may be associated dizziness, particularly on sitting or standing up. One may feel faint during any physical activity.

Rhythm disturbances of the heart induce palpitations or chest discomfort. As the disease progresses, swelling appears on the body. Initially, it appears over the ankles and feet, intermittently, but slowly becomes generalised and present more consistently.

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If untreated, the functioning of various body parts is also affected over time, due to consistently reduced perfusion.

Untreated, the cardiomyopathy progresses, worsening cardiac failure. Due to heart rhythm disturbances, there is a risk of brain damage causing stroke or heart attack.

After clinical suspicion, diagnosis is confirmed by investigations like electrocardiogram, and cardiac echo, which help to see the rhythm pattern and pumping of the heart. Imaging techniques like angiography, C.T. scans, and MRI help to identify any blocks in blood vessels of the heart, the removal of which helps in the improvement of the disease process.

The type of treatment depends on the type of cardiomyopathy and how serious it is.

Medications used to treat cardiomyopathy help improve cardiac contractility, blood flow, and slow heart rate, remove extra fluid and salt from the body, and prevent blood clots. It is important to take these medicines regularly and in prescribed doses.

Lifestyle factors are also very important in preventing the progression of the disease. One should eat a healthy balanced diet, including more fresh vegetables, fruits, whole grains, nuts, and fish. Excess of salt, sugar, and oil should be avoided. The use of alcohol and or tobacco needs to be shunned totally. Regular physical exercise is beneficial in preventing cardiomyopathy. However, once the condition occurs and is diagnosed, physical activity should be restricted and done as per the advice of the treating physician.

Diagnosed early, cardiomyopathy can be reversed by treatment and lifestyle factors. Hence, people need to be more aware of it.

Dr Rachna Pande is a specialist in internal medicine.