Heart Disease - Cardiomyopathy : Diagnosis, Prevention dan Treatment

HOW IS CARDIOMYOPATHY DIAGNOSED?

Based on your medical and family histories, a physical exam, and the results from tests and procedures.

  a)    Specialists Involved

ü  Often, a cardiologist or pediatric cardiologist diagnose and treats cardiomyopathy.A cardiologist specializes in diagnosing and treating heart diseases.A pediatric cardiologist is a cardiologist who treats children.

  b)    Medical and Family Histories

ü  Your doctor will want to learn about your medical history.They want to know what signs and symptoms you have and how long you have had them.

ü  They also want to know whether anyone in your family has had cardiomyopathy, heart failure, or sudden cardiac arrest.

  c)    Physical Exam

ü  Your doctor will use a stethoscope to listen to your heart and lungs for sounds that may suggest cardiomyopathy. This sounds may even suggest a certain type of the disease.

ü  Swelling of the ankles, feet, legs, abdomen, or veins in your neck suggests fluid buildup, a sign of heart failure.

ü  Doctor may notice signs and symptoms of cardiomyopathy during a routine exam.

  d)    Diagnostic Tests

ü  Doctor may recommend one or more of the following tests to diagnose cardiomyopathy:-

·         Blood test. A small amount of blood is taken from your body. It is often drawn from a vein in your arm using a needle. This procedure is quick and easy. Blood tests give information about your heart and help rule out other conditions.

·         Chest X-ray. Takes pictures of the organs and structures inside the chest, such as heart, lungs, and blood vessels. This test can show whether the heart is enlarged and show whether fluid is building up in the lungs.

·         EKG (Electrocardiogram).A simple test that records the hearts’s electrical activity. The test show how fast the heart is beating and its rhythm. This test is used to detect and study many heart problems.

·         Holter and Event Monitors. A small, portable devices. Record heart’s electrical activity while doing normal daily activities. Record heart’s electrical activity for a full 24-or48 hour period.

·         Echocardiography. Is a test that uses sound waves to create a moving picture of heart. The pictures shows how well the heart is working and its size and shape. There a several types of echo, stress echo that show whether you have decreased blood flow to heart and transesophageal echo (TEE) which provide a view of the back of the heart.

·         Stress Test. These tests may include nuclear heart scanning, echo, and positron emission tomography (PET) scanning of the heart.

  e)    Diagnostic Procedures

ü  These procedures may include cardiac catheterization, coronary angiography, or myocardial biopsy.

·         Cardiac Catheterization. Checks the pressure and blood flow in heart’s chambers. The procedure need to collect blood samples and look at the heart’s arteries using x-ray imaging.

·         Coronary Angiography. Often is done with cardiac catheterization. During the procedure, dye that can be seen on an x-ray is injected into coronary arteries. This is to study the blood flow through heart and blood vessels. Dye also may be injected into the heart chambers to study the pumping function of the heart.

·         Myocardial Biopsy. Doctor removes a piece of the heart muscle. This can be done during cardiac catheterization. The heart muscle is studied under a microscope to see wether changes in cells have occurred.

  f)    Genetic Testing

ü  Some types of cardiomyopathy run in families. Thus, doctor may suggest genetic testing to look for the disease in the parents, brothers and sisters, or other family members.

ü  Genetic testing can show how the disease runs in families. It also can find out the chances of parents passing the genes for the disease on to their children.

ü  This also may useful  if  doctor thinks you have cardiomyopathy, but you do not yet have signs and symptoms.

HOW CAN CARDIOMYOPATHY

BE PREVENTED?

The inherited types of cardiomyopathy can not be prevent but several steps needed to lower the risk for diseases or conditions that may lead to or complicate cardiomyopathy.

Doctor may advice you to make heart-healthy lifestyle changes such as :-

         ü  Avoiding the use of alcohol and illegal drugs

         ü  Getting enough sleep and rest

         ü  Heart-healthy eating

         ü  Physical activity

         ü  Quitting smoking

         ü  Managing stress

The cardiomyopathy may be due to an underlying disease or condition. Treat the conditions early enough to prevent cardiomyopathy complications.

HOW IS CARDIOMYOPATHY

TREATED?

People who have cardiomyopathy but no signs and symptoms may not need treatment. Sometimes, dilated cardiomyopathy that comes on suddenly may go away on its own. For other people who have cardiomyopathy, treatment is need. Treatment depends on the type of cardiomyopathy you have, the severity of the symptoms and complications, and age and overall health. 

The main goals of treating this disease include :

·         Controlling signs and symptoms so that the patient can live as normally as possible

·         Managing any conditions that cause or contribute to the disease

·         Reducing complications and the risk of sudden cardiac arrest

·         Stopping the disease from getting worse

Treatments may include :

·         Heart-healthy lifestyle changes

·         Medicines

·         Nonsurgical procedure

·         Surgery and implanted devices

  a)    Heart-Healthy Lifestyle Changes

·         Heart-healthy eating

·         Aiming for a healthy weight

·         Managing stress

·         Physical activity

·         Quitting smoking

  b)    Medicines

·         Balance electrolytes in the body

·         Keep heart beating with a normal rhytm

·         Lower blood pressure

·         Prevent blood clots from forming

·         Reduce inflammation

·         Remove excess sodium from the body

·         Slow heart rate

  c)    Surgery and Implanted Devices

·         Septal Myetomy. Open-heart surgery is used to treat people who have hypertrophic cardiomyopathy and severe symptoms.This is used for younger patients and for people whose medicines are not working well.

·         Surgically Implanted Devices.

·         Heart Transplant. A surgeon replaces a person’s diseased heart with a healthy heart from a deceased donor.

  d)    Nonsurgical Procedure

·         Alcohol septal ablation to treat cardiomyopathy.

·    The doctor injects ethanol through a tube into the small artery that supplies blood to the thickened area of heart muscle.

·        The alcohols kills cells and the thickened tissue shrinks to a more normal size.

·  This procedure allows blood to flow freely through the ventricles, which improves symptoms.