CARDIOMYOPATHY

A disease of the heart muscle

PRESENTED BY:
ALYSHA MARIE L. ECHANO
LAIDY LOUELAINNE A. CASTRO
 BACKGROUND
Cardiomyopathy is a disease that
affects your myocardium (heart
muscle). It causes the heart to have a
harder time pumping blood to the rest
of the body, which can lead to
symptoms of heart failure.
Cardiomyopathy also can lead to some
other serious heart conditions.

Source: Mayo Clinic, 2024

Source: Cleveland Clinic, 2023
 BACKGROUND MAIN TYPES
Hypertrophic cardiomyopathy. In this type, the heart muscle
becomes thickened. This makes it harder for the heart to work. The
condition mostly affects the muscle of the heart's main pumping
chamber. (can start at any age but it tends to be worse if it happens
during childhood. Most people with this type of cardiomyopathy have
a family history of the disease)
Restrictive cardiomyopathy. In this type, the heart muscle becomes
stiff and less flexible. As a result, it can't expand and fill with blood
between heartbeats. (least common type but commonly affects
older people)
Dilated cardiomyopathy. In this type of cardiomyopathy, the heart's
chambers thin and stretch, growing larger. The condition tends to
start in the heart's main pumping chamber, called the left ventricle.
As a result, the heart has trouble pumping blood to the rest of the
body. (can affect people of all ages. But it happens most often in
people younger than 50 and is more likely to affect men.)

Source: Cleveland Clinic, 2023 Source: Mayo Clinic, 2024

PREVALENCE
How common is cardiomyopathy?

Cardiomyopathy can affect anyone of any age, sex or race.

The most common inherited cardiomyopathy, hypertrophic,
affects about 1 in 500 people in the world. Other genetic types
occur in 1 in 2,000 or 2,500 people.

The hospital-based prevalence of cardiomyopathy was

809 per million inhabitants (PMI) per year

Source: Cleveland Clinic, 2023;

Lannou et al., 2020
CAUSES
The cause of the cardiomyopathy isn't known. But some people get it due to
another condition--acquired cardiomyopathy. Other people are born with
cardiomyopathy because of a gene passed on from a parent--inherited
cardiomyopathy.

Certain health conditions or behaviors that can lead to acquired cardiomyopathy include:
Long-term high blood pressure.
Heart tissue damage from a heart attack.
Long-term rapid heart rate.
Heart valve problems.
COVID-19 infection.
Certain infections, especially those that cause inflammation of the heart.
Metabolic disorders, such as obesity, thyroid disease or diabetes.
Lack of essential vitamins or minerals in the diet, such as thiamin (vitamin B-1).
Pregnancy complications.
Iron buildup in the heart muscle, called hemochromatosis.
The growth of tiny lumps of inflammatory cells called granulomas in any part of the body. When
this happens in the heart or lungs, it's called sarcoidosis.
The buildup of irregular proteins in the organs, called amyloidosis.
Connective tissue disorders.
Drinking too much alcohol over many years.
Use of cocaine, amphetamines or anabolic steroids.
Use of some chemotherapy medicines and radiation to treat cancer.

Source: Mayo Clinic, 2024

 PATHOGENESIS
The pathogenesis of cardiomyopathy is complex and multifactorial, involving
genetic, environmental, and lifestyle factors that can interact and trigger a
cascade of events leading to the development of the disease.

GENETIC FACTORS: In many cases, cardiomyopathy can be inherited from one

or both parents in an autosomal dominant pattern, meaning that only one copy
of the mutated gene is required for the disease to manifest.

Mutations in genes encoding for sarcomeric proteins, such as MYH7, MYBPC3,

and TNNT2, develop hypertrophic cardiomyopathy

Mutations in genes encoding for cytoskeletal proteins, such as DES and

LMNA, are more commonly associated with dilated cardiomyopathy.

Source: Cheng T (2023) Understanding the

Pathogenesis of Cardiomyopathy. J Clin
Exp Cardiolog.14:781
 PATHOGENESIS
ENVIRONMENTAL FACTORS, such as:

Viral infections, particularly those caused by Coxsackie B virus and

adenovirus, have been linked to the development of dilated
cardiomyopathy, possibly through the induction of inflammatory and
autoimmune responses in the heart muscle.

Toxins, such as alcohol, cocaine, and anthracyclines, can also cause

cardiomyopathy by directly damaging the heart muscle or by
interfering with its metabolic and biochemical processes.

Chronic alcohol abuse, in particular, can lead to alcoholic

cardiomyopathy, a form of dilated cardiomyopathy characterized by
fibrosis and hypertrophy of the heart muscle.
Source: Cheng T (2023) Understanding the
Pathogenesis of Cardiomyopathy. J Clin
Exp Cardiolog.14:781
PATHOGENESIS
LIFESTYLE FACTORS, such as:

A diet high in saturated fats, cholesterol, and salt can

increase the risk of developing hypertensive and ischemic
cardiomyopathy.
Physical inactivity and sedentary behavior have also been
linked to an increased risk of cardiomyopathy, possibly
through the effects of obesity, insulin resistance, and
inflammation on the heart muscle.
Excessive exercise, particularly endurance sports, can lead
to hypertrophic cardiomyopathy
Stress and psychological factors, such as depression,
anxiety, and chronic stress, have also been associated with
an increased risk of cardiomyopathy.
Source: Cheng T (2023) Understanding the
Pathogenesis of Cardiomyopathy. J Clin
Exp Cardiolog.14:781
 Many things can raise the risk of cardiomyopathy,

TRANSMISSION
including:
Cardiomyopathy is a noncommunicable
disease thus, no transmission occurs.
Family history of cardiomyopathy, heart failure
and sudden cardiac arrest.
Long-term high blood pressure.
Conditions that affect the heart. These include a
past heart attack, coronary artery disease or an
infection in the heart.
Obesity, which makes the heart work harder.
Long-term alcohol misuse.
Illicit drug use, such as cocaine, amphetamines
and anabolic steroids.

RISK FACTORS
Treatment with certain chemotherapy medicines
and radiation for cancer.
Many diseases also raise the risk of cardiomyopathy,
including:
Diabetes.
Thyroid disease.
Storage of excess iron in the body, called
hemochromatosis.
Buildup of a certain protein in organs, called
amyloidosis.
The growth of small patches of inflamed tissue in
organs, called sarcoidosis.
Connective tissue disorders.

Source: Mayo Clinic, 2024

SIGNS AND SYMPTOMS
Cardiomyopathy symptoms can include:
Shortness of breath (dyspnea) or trouble breathing with
activity or even at rest
Chest pain, especially after physical activity or heavy meals.
Heartbeats that feel rapid, pounding or fluttering (Arrhythmia)
Swelling of the legs, ankles, feet, stomach area and neck veins
(edema)
Bloating of the stomach area due to fluid buildup
Cough while lying down
Trouble lying flat to sleep
Fatigue, even after getting rest
Dizziness
Fainting (syncope)

Source: Mayo Clinic, 2024

 DIAGNOSIS
Tests to diagnose cardiomyopathy may include:
Ambulatory monitoring.
Blood tests.
Chest X-ray.
Cardiac CT.
Heart MRI
Echocardiogram
Electrocardiogram (EKG)
Exercise stress test
Cardiac catheterization
Myocardial biopsy

Source: Cleveland Clinic, 2024

PREVENTION
How can I lower my risk of cardiomyopathy?
You can take action to reduce your risk of conditions
that could lead to cardiomyopathy.
Some of these actions include:
Managing your blood pressure.
Keeping your cholesterol within healthy ranges.
Getting regular exercise.
Avoiding tobacco products, alcohol and cocaine.
Managing underlying conditions such as sleep
apnea or diabetes.
Scheduling regular checkups with a healthcare
provider.
Taking all medications as prescribed.
TREATMENT
MEDICATIONS can improve your blood flow and manage your symptoms.
Antihypertensives.
Blood thinners (anticoagulants).
Antiarrhythmics.
Medications to lower cholesterol.
Aldosterone antagonists.
Corticosteroids
Devices to correct arrhythmias (irregular heart rhythms). These devices
monitor your heartbeat.
Pacemakers.
Implantable cardioverter defibrillators (ICDs).
Devices to improve blood flow
Some devices help your heart pump blood more efficiently. You may receive
one of these devices:
Cardiac resynchronization therapy (CRT).
Left ventricular assist device (LVAD).
PROCEDURES
If you have severe symptoms or underlying heart conditions, your provider
may recommend a procedure. Some of these involve surgery.
Rarely used procedures may include:
Septal myectomy.
Heart transplant.
Alcohol septal ablation.
Catheter ablation.
Source: Cleveland Clinic, 2024
COMPLICATIONS
Cardiomyopathy can lead to serious medical conditions,
including:
Heart failure. The heart can't pump enough blood to meet
the body's needs. Without treatment, heart failure can be
life-threatening.
Blood clots. Because the heart can't pump well, blood clots
might form in the heart. If clots enter the bloodstream, they
can block the blood flow to other organs, including the heart
and brain.
Heart valve problems. Because cardiomyopathy can cause
the heart to become larger, the heart valves might not close
properly. This can cause blood to flow backward in the valve.
Cardiac arrest and sudden death. Cardiomyopathy can
trigger irregular heart rhythms that cause fainting.
Sometimes, irregular heartbeats can cause sudden death if
the heart stops beating effectively.
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LISTENING
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