What is a cardiomyopathy?
Cardiomyopathy is a medical term used to explain that there is a heart (Cardio) muscle (myo) disorder or problem (pathy).

There are four types of Cardiomyopathy:

• Dilated Cardiomyopathy(DCM)
• Hypertrophic Cardiomyopathy(HCM)
• Restrictive Cardiomyopathy(RCM)
• Arrhythmogenic Right Ventricular Cardiomyopathy(ARVC)

Dilated Cardiomyopathy
Dilated Cardiomyopathy (DCM) is a condition where the heart has become enlarged and the heart muscle does not pump as well as normal. As a result of this there are some occasions when the muscle of the heart is unable to pump blood efficiently around the body. When this occurs, it causes some fluid to build up in thelungs, which may give you that feeling of breathlessness as your lungs area little heavier with the extra fluid. This is called congestion and is due to left heart failure.

Now do not be alarmed at that term which simply means that the heart is not pumping as well as it should. It does not mean your heart will stop. There can also be a problem with the muscle of the right side of the heart to give one right heart failure. As with the left side, this simply means that the right heart is less good at pumping blood and this may cause fuid to build up inthe tissues and organs of the body, usually the legs and ankles, and the liver and abdomen.Right heart failure may also develop independently of a cardiomyopathy when a patient has lung problems like emphysema and the right side of the heart is not able to cope with the increased work required to pump blood up to the diseased lungs. In these individuals, their left heart muscle functions normally.

Dilated cardiomyopathy is usually caused by narrowed arteries and heart attacks but may also be due to untreated longstanding high blood pressure where the heart, having first thickened in response to the extra work, eventually starts to weaken and dilate. Myocarditis or inflammation of the heart muscle from toxins like alcohol or certain cancer drugs can cause a dilated cardiomyopathy. However, sometimes people present with a dilated cardiomyopathy and the cause is unclear. It is postulated that their heart may have been damaged by certain viruses and that they may have a genetic weakness that makes their heart muscle susceptible to injury. There are also some families where a number of members are affected with a dilated cardiomyopathy and this is considered a hereditary cardiomyopathy. Rarely, cardiomyopathy may occur in association with pregnancy and childbirth and is referred to as post partum cardiomyopathy which can be life threatening for both mother and child. Fortunately this is a rare condition.

Hypertrophic Cardiomyopathy
Hypertrophic Cardiomyopathy is a condition where there is an increased thickening of the heart muscle. This is different to when the heart muscle may thicken in individuals as a result of high blood pressure or athletic training.

In hypertrophic Cardiomyopathy (HCM), however, the muscle thickening occurs without an obvious cause. The main problem with this condition is that the muscle thickening may prevent the heart from pumping the blood as efficiently as normal. The thickening may be predominantly in the septum just below the aortic valve where the blood leaves the ventricle. It is this obstruction to the outflow that may cause dizziness or collapse which can often be how these patients present. In some individuals, there is a risk of heart rhythm disturbance so an implantable cardioverter defibrillator (ICD) is required.

Excessive exertion is not recommended for those with this condition.There is a significant family link with this condition and patients are advised to have their 1st degree relatives screened.

Restrictive Cardiomyopathy
This is a rare form of Cardiomyopathy where the heart muscle becomes stiff and cannot relax. As a result the heart cannot pump blood around the body efficiently.

Arrhythmogenic Right Ventricular Cardiomyopathy
In this condition there is a change in the structure of the right side of the heart muscle so that it is thinner and contains more fat and fibrous tissue than normal.

As a result of this the right heart may be more prone to abnormal rhythms and also not to pump as well as normal. This is not a very common condition but there is a strong hereditary link and so 1st degree relatives should be screened. Patients are at risk of sudden death and so may need an implantable cardioverter defibrillator (ICD) for prevention.

Cardiomyopathy Support Group
This support group is a voluntary group set up in association with the Irish Heart Foundation to assist patients and families affected with the condition. The members consist of patients and their families.

The support group also wishes to create more awareness of the condition in Ireland so that more individuals with the condition are helped. It must be remembered that having a cardiomyopathy does not necessarily mean that you are going to have lifelong problems. There are many individuals in whom this diagnosis was only made who go on to have a long and healthy life.

However, because it does carry a higher risk of problems than in those without cardiomyopathy, it is important to be screened for this condition if your relatives are affected. Screening by a cardiologist would involve a lengthy review of your family history soits useful to have phonedyour relatives to have all the detaisl available beforehand, a review of any symptoms of concern like breathlessness or dizziness, a physical examination and ECG and you may need an echocardiogram to exclude a cardiomyopathy.

Links
www.cardiomyopathy.org is the official web page of the Cardiomyopathy association in the UK to help sufferers and medical professionals to find ways to deal with the condition. Through campaigning they promote medical screening and early recognition of the disease.

They have produced a number of informative booklets for patients. At present membership is £15 Sterling.