The management of cardiomyopathy aims to reduce your signs and symptoms, prevent your condition from worsening, and decrease your risk of complications. Treatment varies by which of the major types of cardiomyopathy you have.
In this condition, your doctor may recommend medications, surgically implanted devices or a combination of both. The medications you may be prescribed include:
- Angiotensin-converting enzyme (ACE) inhibitors: These improve your heart’s pumping capability.
- Angiotensin receptor blockers (ARBs): These are for patients who can’t take ACE inhibitors.
- Beta blockers: These improve heart function.
- Digoxin (Lanoxin): Also called as digitalis, this medication increases the strength of your heart muscle contractions. It also tends to slow the heartbeat.
- Diuretics: These are the “water pills” that make you urinate more frequently and keep fluid from collecting in your body.
In some cases, a special pacemaker is implanted that coordinates the contractions between the left and right ventricles (biventricular pacing). Drug therapy or an implantable cardioverter-defibrillator (ICD) may be options in people who may be at risk of serious arrhythmias.
In this condition, your doctor may recommend beta blockers to relax your heart, slow its pumping action and stabilize its rhythm. These medications also calcium channel blockers, such as verapamil. In hypertrophic cardiomyopathy, medications are often the preferred treatment. You may need surgery or a medical device to treat your condition if medications don’t work. Options include:
Septalmyectomy: It is a type of an open-heart operation in which the surgeon removes part of the thickened, overgrown heart muscle wall (septum) that separates the two bottom heart chambers (ventricles). This removal improves blood flow and reduces mitral regurgitation. Most patients improve with this surgery and have no further symptoms.
Septal ablation: In this treatment, a small portion of the thickened heart muscle is destroyed by injecting alcohol through a catheter into the artery supplying blood to it. There are possible complications with this procedure, including heart block — a disruption of the heart’s electrical system — which requires implantation of a pacemaker. Although the long-term success of this procedure isn’t yet known, it’s becoming more commonly used.
Pacemaker implantation: In this procedure, a small electronic device is inserted under your skin that sends electrical signals to your heart to monitor and regulate your heartbeat. This procedure is generally done under local anesthesia and typically takes less than three hours. But, this procedure is not as effective as surgical options, but it’s sometimes used in older people who want to avoid more invasive procedures. Implantable cardioverter-defibrillator (ICD).In this procedure, a pager-sized device is implanted in your chest like a pacemaker. This device continuously monitors your heartbeat. In case a life-threatening arrhythmia is detected, the ICD delivers precisely calibrated electrical shocks to restore a normal heart rhythm. In patients at risk of a sudden cardiac death because of abnormal heart rhythms, this device is very useful.
The management of this condition aims at improving symptoms. The advice you will receive from a doctor will recommend you to pay careful attention to your salt and water intake and monitor your weight daily. Diuretics might be recommended if sodium and water retention becomes a problem. Blood pressure lowering medications also may be prescribed to lower your blood pressure and control fast or irregular heart rhythms.
Heart transplant and ventricular assist devices (VADs)
A heart transplant may be an option if you have severe cardiomyopathy and medications can’t control your symptoms. Even people who are critically ill may have a long wait before having a heart transplant because of the shortage of donor’s hearts. A mechanical heart assist device can help In some patients who are critically ill as they wait for an appropriately matched donor. These devices, known as ventricular assist devices (VADs), can help blood circulate through your heart for months or even years.VAD therapy could be a long-term treatment option for some people who aren’t candidates for a heart transplant.
Choose the following lifestyle measures to help you manage cardiomyopathy:
- Quit smoking.
- Lose excess weight.
- Eat a low-salt diet.
- Get modest exercise after discussing with your doctor the most appropriate program of physical activity.
- Eliminate or minimize the amount of alcohol you drink.
Specific recommendations will depend on the type of cardiomyopathy you have.
Generally, you can’t prevent cardiomyopathy in many cases. If you have a family history of the condition, consult a doctor. If cardiomyopathy is diagnosed early, treatments may prevent the disease from worsening. Preventing the diseases that cause cardiomyopathy is the best to prevent it. Know your risk factors for coronary artery disease and modify those risks early in life. You can reduce your risk of coronary artery disease by:
- Having a normal blood pressure. Eat a diet rich in vegetables and fruits. Take medication as needed.
- Not taking more than two alcoholic beverages per day. Do not drink alcohol at all if you are at high risk of dilated cardiomyopathy.
Contact your doctor for the evaluation if you have any family members with inherited cardiomyopathy.