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Cardiomyopathy is any disease of the heart muscle in which the heart loses its ability to pump blood effectively. In some instances, the heart rhythm is disturbed, leading to irregular heartbeats, called arrhythmias or dysrhythmia. There are multiple causes of cardiomyopathy, including viral infections. Sometimes, the exact cause of the muscle disease is never found.
For in-depth visual and audio information on this condition, visit the Children's Hospital Boston Multimedia Library.
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Cardiomyopathy differs from many of the other disorders of the heart in several ways, including the following:
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- Cardiomyopathy can, and often does, occur in the young.
- The condition is fairly uncommon, affecting only about 50,000 Americans (adults and children).
- Cardiomyopathy is a leading diagnosis that results in heart transplantation.
- The condition can be progressive and sometimes worsens quickly.
- It may be associated with diseases involving other organs, in addition to the heart.
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Cardiomyopathy can prevent the heart muscle from pumping enough blood to meet the body's needs, a condition called congestive heart failure. It can also cause blood pressure in the lungs to become higher than normal, a condition called pulmonary hypertension.
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Viral infections that infect the heart are a major cause of cardiomyopathy. In some instances, cardiomyopathy is a result of another disease or its treatment, such as complex congenital (present at birth) heart disease, nutritional deficiencies, uncontrollable, fast heart rhythms, or certain types of chemotherapy for childhood cancers. Sometimes, cardiomyopathy can be linked to a genetic abnormality. Other times, the cause is unknown.
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The following types of cardiomyopathy commonly affect children:
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- Dilated (congestive) Cardiomyopathy -- This is the most common form of cardiomyopathy. The heart muscle is enlarged and stretched, causing the heart to become weak and pump inefficiently. Other problems that may occur with dilated cardiomyopathy include the following:
- irregular heart rhythms (arrhythmia or dysrhythmia)
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Various infections (including viral) that lead to an inflammation of the heart muscle (myocarditis) can cause this type of cardiomyopathy.
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Contact with toxins or very powerful therapeutic drugs, such as certain types of chemotherapy given to fight cancer, have been known to cause dilated cardiomyopathy. Heredity also can be a factor. Twenty percent of people with dilated cardiomyopathy have a parent or sibling with the disease. In many cases, a specific cause for this type of the disease is never identified.
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Because the heart muscle is weak and unable to pump enough blood to meet the body's demands, the body tries to preserve blood flow to essential organs such as the brain and kidneys by reducing blood flow to other areas of the body, such as the skin and muscles.
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The following are the most common symptoms of dilated cardiomyopathy. Each child may experience symptoms differently. Symptoms may include:
- pale or ashen skin color
- cool, sweaty skin
- rapid heart rate
- rapid breathing rates
- shortness of breath
- fatigue
- irritability
- chest pain
- poor appetite
- slow growth
- vomiting, abdominal pain
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Specific treatment for dilated cardiomyopathy will be determined by your child's physician based on:
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your child's age, overall health and medical history
- extent of the disease
- your child's tolerance for specific medications, procedures or therapies
- how your child's doctor expects the disease will progress
- your opinion or preference
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Your child's physician may recommend medications to accomplish the following:
- help the heart beat more effectively
- decrease the workload of the heart
- decrease the oxygen requirements of the heart
- prevent clots from forming
- decrease inflammation of the heart
- regulate irregular heartbeats
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In some cases, dilated cardiomyopathy that is due to viral causes improves. In other cases, the condition worsens and transplantation of the heart may be considered. Consult your child's physician for more information regarding the specific outlook for your child.
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- Hypertrophic Cardiomyopathy (also known as hypertrophic obstructive cardiomyopathy, HOCM; asymmetric septal hypertrophy, ASH; or idiopathic hypertrophic subaortic stenosis, IHSS) -- In this type of cardiomyopathy, the muscle mass of the left ventricle of the heart is larger than normal, or the wall between the two ventricles (septum) becomes enlarged. These abnormalities may obstruct the blood flow from the left ventricle.
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The thickened muscle or septal wall also can affect one of the leaflets of the mitral valve, which separates the left atrium and the left ventricle. The valve becomes leaky, allowing blood to move backward from the left ventricle into the left atrium, instead of forward to the body.
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Hypertrophic cardiomyopathy is often hereditary. Half of children with the disease have a parent or sibling with varying degrees of left ventricular muscle or ventricular wall enlargement, although relatives may or may not have symptoms.
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Children with hypertrophic cardiomyopathy may have symptoms that increase with exertion, or symptoms may be unpredictable.
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The following are the most common symptoms of hypertrophic cardiomyopathy. Each child may experience symptoms differently. Symptoms may include:
- dizziness
- fainting
- chest pain
- abnormal heart rhythms
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Specific treatment for hypertrophic cardiomyopathy will be determined by your child's physician based on:
- your child's age, overall health and medical history
- extent of the disease
- your child's tolerance for specific medications, procedures or therapies
- how your child's doctor expects the disease to progress
- your opinion or preference
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Your child's physician may recommend medications to accomplish the following:
- decrease the workload of the heart
- decrease the oxygen requirements of the heart
- regulate irregular heartbeats
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Surgical treatments may include:
- removal of part of the enlarged muscle
- artificial pacemaker
- heart transplantation
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Consult your child's physician for more information regarding the specific outlook for your child.
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Complementing the Cardiovascular Program of Children's Hospital Boston is the nation's most intensive clinical and basic research program focused on pediatric heart disease. Children's is a world leader in opening new avenues of "translational research," bringing laboratory advances to the bedside and doctor's office as quickly as possible. All senior medical staff members of the Cardiovascular Program participate in clinical research activities.
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Contact Children's Hospital Boston Cardiovascular Program physicians for a second opinion.
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Cardiomyopathy
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