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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.

Faq's

What are heart muscle diseases?

Heart muscle diseases, also known as cardiomyopathies, refer to a group of conditions that affect the structure and function of the heart muscles. These diseases can lead to abnormal heart rhythms, reduced pumping ability, and other complications.

How is the risk stratification for heart muscle diseases done?

Risk stratification involves assessing an individual's risk of developing severe symptoms or experiencing life-threatening events related to their heart muscle disease. This process typically includes evaluating various factors such as family history, genetic testing results, imaging studies (echocardiogram), and clinical symptoms.

What is invasive hemodynamic assessment in relation to heart muscle diseases?

Invasive hemodynamic assessment involves measuring pressures within the chambers of the heart using specialized catheters inserted through blood vessels. This procedure helps determine specific parameters like cardiac output and pressure measurements that aid in diagnosing and managing certain types of heart muscle diseases.

When is ablation used in treating heart muscle diseases?

Ablation may be considered as a treatment option for certain types of arrhythmias associated with heart muscle diseases. This minimally invasive procedure uses radiofrequency energy or cryotherapy to target and destroy abnormal tissue causing irregular electrical signals in the heart.

Who might require ICD implantation for managing their heart muscle disease?

Implantable cardioverter-defibrillator (ICD) devices are often recommended for individuals at high risk of sudden cardiac arrest due to their underlying heart muscle disease or previous cardiac events like ventricular tachycardia or fibrillation.

What is cardiac resynchronization therapy (CRT) used for in patients with heart muscle diseases?

Cardiac resynchronization therapy aims to improve synchrony between different parts of the heartbeat by using a specialized pacemaker device called a CRT device. It is beneficial for certain individuals with heart muscle diseases, particularly those experiencing electrical conduction issues that can lead to heart failure symptoms.