March 11, 2011 | Cardiomyopathy, the condition that claimed the life of Michigan high school athlete Wes Leonard earlier this month, refers to diseases of the heart muscle, diseases that have a variety of causes, symptoms and treatments. In cardiomyopathy, the heart muscle becomes enlarged, thick, or rigid. In rare cases, the muscle tissue in the heart is replaced with scar tissue. As the disease worsens, the heart becomes weaker, less able to pump blood through the body and maintain a normal electrical rhythm. This can lead to heart failure, which, in turn, can cause fluid to build up in the lungs, ankles, feet, legs, or abdomen. The weakening of the heart also can cause other severe complications, such as heart valve problems. Cardiomyopathy predominately affects adults but it does affect infants and children, too. According to the Pediatric Cardiomyopathy Registry, one in every 100,000 children is diagnosed with symptoms of the disease each year.

March 11, 2011 | Dilated cardiomyopathy is the most common type of the disease. It mostly occurs in adults aged 20 to 60. Men are more likely than women to have this type of cardiomyopathy. Dilated cardiomyopathy affects the ventricles and atria, the lower and upper chambers of the heart, respectively. The disease often starts in the left ventricle, the heart’s main pumping chamber. The heart muscle begins to dilate, or stretch and become thinner, causing the inside of the chamber to enlarge. The problem often spreads to the right ventricle and then to the atria as the disease gets worse. When the chambers dilate, the heart muscle doesn’t contract normally. Also, the heart can’t pump blood very well. Over time, the heart becomes weaker and heart failure can occur. The symptoms of heart failure can include fatigue, swelling of the ankles, feet, legs, and abdomen and shortness of breath. Dilated cardiomyopathy also can lead to heart valve problems and blood clots.

March 11, 2011 | Hypertrophic cardiomyopathy can affect people of any age. About 1 out of every 500 people has this type of cardiomyopathy, which affects men and women equally. Hypertrophic cardiomyopathy is the most common cause of sudden cardiac arrest, or SCA, in young people, including young athletes like former Loyola Marymount star Hank Gathers. This type of cardiomyopathy occurs when the walls of the ventricles, usually the left ventricle, thicken. Despite this thickening, the ventricle size often remains normal. Hypertrophic cardiomyopathy may block blood flow out of the ventricle. When this happens, the condition is called hypertrophic obstructive cardiomyopathy. In some cases, the septum, the wall that divides the left and right sides of the heart, thickens and bulges into the left ventricle. In both cases, blood flow out of the left ventricle is blocked. As a result, the ventricle must work much harder to pump blood to the body.

March 11, 2011 | Two of the less common forms of cardiomyopathy are restrictive cardiomyopathy and arrhythmogenic right ventricular dysplasia or ARVD. Restrictive cardiomyopathy tends to mostly affect older adults. In this type of the disease, the ventricles become stiff and rigid due to abnormal tissue, such as scar tissue, replacing the normal heart muscle, or other rare causes such as multiple myeloma, that infiltrates the heart muscle, prohibiting its normal function. As a result, the ventricles can’t relax normally and fill with blood, and the atria become enlarged. Over time, blood flow in the heart is reduced. This can lead to problems such as heart failure or arrhythmias. ARVD occurs when the muscle tissue in the right ventricle is replaced with fibrous tissue. This process disrupts the heart’s electrical signals and causes arrhythmias. ARVD usually affects teens or young adults and can cause sudden cardiac arrest in young athletes. But fortunately, such deaths are rare.

March 11, 2011 | People who have the heart disease cardiomyopathy but display no signs of it may not need medical treatment but need to follow up with their doctors. Sometimes, dilated cardiomyopathy that comes on suddenly may even go away on its own. For other people with the disorder, treatment is needed. Dr. Ibrahim Fahdi, a UAMS cardiologist, says the treatment depends on the type of cardiomyopathy you have, the severity of your symptoms and your age and overall health. The main goals of treating cardiomyopathy are managing any conditions that cause the disease and controlling signs and symptoms so that you can live as normally as possible. It’s also important to stop the disease from getting worse as well as reducing complications and the risk of sudden cardiac arrest. Some of the treatments options may include lifestyle changes, medications, surgery, implanted devices to correct irregular heartbeats, or a non-surgical procedure.