Overview of Adults and Cardiomyopathy

Enlarged Heart Diagnoses Vary Greatly

(LifeWire) - A flight attendant for nearly 25 years, Janette DeMets was accustomed to lifting heavy suitcases and acclimating to different cities' altitudes. After recurring bouts of breathlessness and fatigue so extreme she had trouble pulling her own bag from gate to gate, though, DeMets was diagnosed with cardiomyopathy, a chronic disease in which the heart muscle has become inflamed or thickened and can't work as efficiently.

Cardiomyopathy affects about 500,000 Americans; some are born with the condition, but most are diagnosed in middle age. Severity and causes vary widely, but even patients with more serious cases can lead active lives with the right treatment.

DeMets, for example, ultimately went on disability, takes 10 medications a day and lives with an implanted cardiac defibrillator (ICD) to regulate her heartbeats. The 63-year-old Scottsdale, Ariz., resident, though, still plays golf and volunteers at a hospital, counseling newly diagnosed heart patients.

One Disease, Several Forms

In all cases of cardiomyopathy, the heart has trouble pumping blood because of poor cardiac muscle tone.

DeMets' condition, dilated cardiomyopathy, is the most common type of cardiomyopathy. It mostly affects the left ventricle, which is the heart's main pumping chamber. The left ventricle becomes enlarged, or dilated, and, as a result, can't pump enough blood through the body.Read more about dilated cardiomyopathy here.

Hypertrophic cardiomyopathy is the type most often diagnosed after an athlete -- seemingly in his or her prime -- dies suddenly on the basketball court or the football field. It's characterized by a thickening of the heart muscle's wall but is hard to detect before a medical emergency strikes, because its symptoms (dizziness, fainting and heart murmur) are often not present in the early stages.

As a result, hypertrophic cardiomyopathy may not show up on an echocardiogram (heart ultrasound) until adolescence. Teenage and young adult athletes who have a family history of hypertrophic cardiomyopathy should have an echocardiogram even if they have no symptoms. Read more about hypertrophic cardiomyopathy here.

Another form, restrictive cardiomyopathy (rigidity in the ventricular muscles) is much less common. Its signs include tiredness, trouble breathing and swollen hands and feet. Read more about diastolic heart failure (the most common type of restrictive heart disease) here.

Causes and Treatments

The exact cause of cardiomyopathy is known in only a quarter of all cases. Genetics, auto-immune disease, viral infection and heart attacks are all believed to play roles in its development. In adults, the disease may also stem from several factors that can be controlled, including alcoholism and high blood pressure.

Patients can contribute to their heart health by abstaining from alcohol, eating wisely, maintaining a healthy weight and exercising under the guidance of a cardiologist.

Several tests may confirm cardiomyopathy. An electrocardiogram (EKG) detects irregular heart rhythms. An echocardiogram measures the heart's pumping ability. Its results are measured in ejection fraction (EF), and cardiomyopathy is diagnosed if the EF level is less than 50%.

Cardiomyopathy is not considered curable, but some patients completely recover for reasons that are not clear.

A variety of medications, such as ACE inhibitors, beta blockers and diuretics (water pills), may be used to combat symptoms and prevent the condition from getting worse. Pacemakers and ICDs can be implanted to maintain a normal heartbeat.

DeMets, who thinks she developed the condition after a virus, makes a point of staying fit.  She works out for 2.5 hours, 3 days a week at a cardiac rehabilitation center. "I go Mondays, Wednesday and Fridays," she says. "I call it my job now."

Read all about cardiomyopathy and heart failure here.

Sources: