Heart Muscle Diseases

Heart muscle diseases are also known as cardiomyopathies. These diseases affect the muscles of the heart. Patients with cardiomyopathy have thickened heart muscles with scar tissues. The heart cannot pump an adequate quantity of blood to the body due to diseased muscles.

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  • Diagnosis: The diagnosis of cardiomyopathy can be made through several methods. These include an echocardiogram, electrocardiogram, chest X-ray, cardiac CT scan, cardiac catheterization, cardiac MRI, stress tests, Holter monitor, genetic screening, myocardial biopsy, coronary angiography, and blood tests.
  • Risk Stratification: The categorization of patients based on risk plays an important role in managing cardiomyopathy. Cardiopulmonary exercise testing may be considered for obtaining prognostic information, particularly when the patient presents with heart failure. Metabolism Exercise Cardiac Kidney Index score and cardiopulmonary exercise testing data enhance risk stratification in these patients.
  • Invasive Hemodynamic Assessment: Several methods exist to assess hemodynamics in patients with cardiomyopathy complicated by heart failure. The assessment parameters include contractility, diastolic function, ventricular–arterial interaction, afterload, right heart dysfunction, and pulmonary hypertension. Invasive hemodynamic assessment is particularly important in patients whose diagnosis is unclear with echo-Doppler imaging and plasma natriuretic peptide levels.
  • Ablation: It is a non-surgical procedure for the treatment of cardiomyopathy. It includes septal and radiofrequency ablation. Septal ablation involves injecting alcohol through a catheter into the artery that provides blood to the thickened heart muscles to destroy them. Radiofrequency ablation involves guiding the catheter with an electrode at the tip to the place generating the abnormal rhythm. The electrode generates energy to damage the spot.
  • ICD Implantation: An implantable cardioverter-defibrillator is placed under the skin and is connected to the heart through leads. The function of the ICD is to detect abnormal heart rhythms and generate shock if an abnormal rhythm is detected. In addition, ICD prevents sudden cardiac arrest and corrects arrhythmia.
  • Cardiac Resynchronization Therapy (CRT): CRT ensures the optimal cardiac rhythm. Pacemakers are placed to restore a normal heart rhythm. Compared to pacemakers with one or two wires, CRT has three leads. One lead goes into the right ventricle, the second into the left ventricle, and the third into the right atrium.