Cardiomyopathy is a chronic heart muscle disease that leads to impaired blood pumping and can result in arrhythmias and heart failure. There are four main types: dilated, hypertrophic, restrictive, and arrhythmogenic right ventricular cardiomyopathy, each with distinct causes and characteristics. Diagnosis involves imaging and electrical tests, while treatment options include medications, lifestyle changes, and in severe cases, surgery.

1. By:
Anand kumar Gond
M.Pharm Pharmacology
(32/MPH/2015)
DIPSAR, University of Delhi

2. INTRODUCTION:
• Cardiomyopathy is a chronic disease of the heart muscle (myocardium), in which the
muscle is abnormally
 enlarged
 thickened and/or stiffened
• The weakened heart muscle loses the ability to pump blood effectively, resulting in
irregular heartbeats (arrhythmias) and possibly even heart failure.

3. Description
• Cardiomyopathy, a disease of the heart muscle, primarily affects the left ventricle,
which is the main pumping chamber of the heart.
• The disease is often associated with inadequate heart pumping and other heart
function abnormalities. Cardiomyopathy is not common (affecting about 50,000 persons
in the United States) but it can be severely disabling or fatal.
• Severe cases may result in heart failure and will require a heart transplant for patient
survival. Cardiomyopathy is a heart condition that not only affects middle-aged and
elderly persons, but can also affect infants, children, and adolescents.
• There are four major types of cardiomyopathy:
• Dilated (congestive cardiomyopathy).
• Hypertrophic cardiomyopathy.
• Restrictive cardiomyopathy.

4. Dilated (congestive cardiomyopathy):
• Dilated (congestive cardiomyopathy): This is the most common form of the disease.
The heart cavity is enlarged and stretched (cardiac dilation), which results in weak and
slow pumping of the blood, which in turn can result in the formation of blood clots.
• Abnormal heart rhythms (arrhythmias) and disturbances in the electrical conduction
processes in the heart may also occur.
• Most patients with this type of cardiomyopathy develop congestive heart failure. There
is also a genetically-linked cardiac disease, Barth syndrome, that can cause dilated
cardiomyopathy.
• This syndrome affects male children, and is usually diagnosed at birth or within the first
few months of life. Pregnant women during the last trimester of pregnancy or after
childbirth may develop a type of dilated cardiomyopathy referred to as peripartum
cardiomyopathy.

5. Hypertrophic Cardiomyopathy
• Hypertrophic cardiomyopathy: With this type of cardiomyopathy, the muscle mass
of the left ventricle enlarges, or hypertrophies. In hypertrophic obstructive
cardiomyopathy (HOCM), the septum (wall) between the two heart ventricles (the
pumping chambers) becomes enlarged and obstructs blood flow from the left
ventricle.
• The thickened wall can also distort one leaflet of the mitral valve, which results in
leakage. HOCM is most common in young adults.
• HOCM is often hereditary, caused by genetic mutations in the affected person's
DNA. The disease is either inherited through one parent who is a carrier or
through both parents who each contribute a defective gene.
• HOCM is also referred to as asymmetrical septal hypertrophy (ASH) or idiopathic
hypertrophic subaortic stenosis (IHSS). In another form of hypertrophic
cardiomyopathy, non-obstructive cardiomyopathy, the enlarged heart muscle does
not obstruct the blood flow through the heart.

6. Restrictive cardiomyopathy.
• Restrictive cardiomyopathy. This is a less common type of cardiomyopathy, in which
the heart muscle of the ventricles becomes rigid.
• Restrictive cardiomyopathy affects the diastolic function of the heart, that is, it affects
the period when the heart is relaxing between contractions.
• Since the heart cannot relax adequately between contractions, it is harder for the
ventricles to fill with blood between heartbeats. This type of cardiomyopathy is usually
the result of another disease.

7. Arrythmogenic right ventricular
cardiomyopathy
• Arrhythmogenic right ventricular cardiomyopathy (ARVC):
• ARVC is very rare and is believed to be an inherited condition.
• With ARVC, heart muscle cells become disorganized and damaged and are replaced
by fatty tissues.
• The damage appears to be a result of the body's inability to remove damaged cells.
• The damaged cells are replaced with fat, leading to abnormal electrical activity
(arrhythmias) and abnormal heart contractions.
• ARVC is the most common cause of sudden death in athletes.

8. causes
• Cardiomyopathy may be caused by many different factors, including
• viral infections (e.g., myocarditis),
• heart attacks,
• alcoholism,
• long-term, severe high blood pressure,
• genetic neuromuscular diseases (e.g., muscular dystrophies and ataxias),
• genetic metabolic disorders, complications from AIDS, and other reasons that have not
yet been identified (idiopathic cardiomyopathy).
• Cardiomyopathy caused by heart attacks (referred to as ischemic cardiomyopathy)
results from scarring in the heart muscle. Larger scars or more numerous heart attacks
increases the risk that ischemic cardiomyopathy will develop. Alcoholic cardiomyopathy
usually develops about 10 years after sustained, heavy alcohol consumption. Other
toxins that may cause cardiomyopathy include drugs and radiation exposure.

9. symptoms
• The major symptoms of cardiomyopathy include:
• shortness of breath
• temporary and brief loss of consciousness, especially after engaging in activity
• lightness, especially after engaging in activity
• decreased ability to tolerate physical exertion
• fatigue
• dizziness
• palpitations, that is, the sensation of feeling the heart beat
• chest pain (angina), whereby there is a feeling of sharp and unrelenting pressure
in the middle of the chest (especially experienced by persons whose
cardiomyopathy is a result of a previous heart attack)
• high blood pressure

10. • Other symptoms that may be associated with cardiomyopathy include:
• abdominal swelling or enlargement
• swelling of legs or ankles
• low amount of urine during the daytime, but a need to urinate at night
• decreased alertness and difficulty concentrating
• cough
• loss of appetite

11. Diagnosis
• Common tests & procedures
• X-ray: Chest X-ray allows for the estimation of heart size and shows the
presence/absence of any lung fluid.
• Echocardiogram: Produces a detailed image of the heart and valves using sound
waves.
• Electrocardiogram (ECG or EKG): Gives the electrical activity of the heart.
• Stress test: Consists of monitoring the electrocardiogram during extreme exercise to
look for changes that may be related to arterial occlusion.

12. Treatments available
• Medication
Anticoagulants: Used to prevent formation of blood clots, and dissolve any
clots that have been formed.
• Warfarin
Beta blockers: Used to slow the heart rate and decrease any load on the
heart.
• Atenolol
ACE inhibitors: These work by relaxing blood vessels and lowering the blood
pressure.
• Lisinopril
Diuretics: Used to increase the rate of production of urine thus removing the
accumulated fluid.
• Furosemide . Torsemide . Ethacrynic acid

13. Nutrition
• Nutrition
• Foods to eat:
• Foods rich in vitamin B1 such as beans, cauliflower, broccoli, asparagus
• Foods low in sodium such as milk, cream cheese, eggs, corn
• Turmeric
• Raw garlic
• Foods to avoid
• Salty Foods
• Fatty Foods such as fast Foods, deep fried Foods, butter
• Avoid alcohol consumption

14. •Thank You
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