What Is Nonischemic Cardiomyopathy?
When lower blood flow isn't the cause of your heart muscle troubles, it's known as nonischemic cardiomyopathy. Rather, autoimmune disorders, infections, and genetics are the reasons.
The medical word for issues relating to the heart muscle is cardiomyopathy. Physicians frequently classify these ailments based on the underlying aetiology.
The cause of ischemic cardiomyopathies is a decrease in heart blood flow. Heart attacks and clogged arteries are frequent examples.
Conversely, nonischemic cardiomyopathies do not result from decreased heart blood flow. Autoimmune diseases and viral infections are examples of potential causes.
This article examines the signs, prognosis, and course of treatment of a few prevalent forms of nonischemic cardiomyopathy.
What causes nonischemic cardiomyopathy?
The function of the heart is to circulate blood throughout your body. Every time it beats, a healthy heart pumps out between 55 and 70 percent of the blood inside.
If your heart beats faster or slower than that, there's usually an issue. The issue may be nonischemic or ischemic. Coronary artery disease is the most common cause of ischemic cardiomyopathy.
The following are typical causes of nonischemic cardiomyopathy:
- autoimmune diseases, including rheumatoid arthritis and lupus
- hereditary disorders including muscular dystrophy and hypertrophic cardiomyopathy
- infections and inflammation (myocarditis), such as Lyme disease and COVID-19
- diseases that infiltrate, such as hemochromatosis and amyloidosis
- prolonged usage of specific pharmaceuticals, like chemotherapeutic drugs
- metabolic diseases, including diabetes and thyroid issues
- high blood pressure (hypertension)
- toxins, such as alcohol, cocaine, and methamphetamines
- stress
- heart rhythm problems
There are situations when nonischemic cardiomyopathy has an unclear aetiology. Idiopathic nonischemic cardiomyopathy is the term for this.
What are the symptoms of nonischemic cardiomyopathy?
Nonischemic cardiomyopathy may present with no symptoms at all or with symptoms resembling heart failure or another cardiac condition. These may consist of:
- shortness of breath
- swelling (edema) in the lower half of the body
- chest pain
- dizziness and fainting
- heart palpitations
- sudden weight gain
- weakness and fatigue
- irregular heartbeat (arrhythmia)
Depending on the underlying cause of your nonischemic cardiomyopathy, you may experience other symptoms. For instance, nerve issues such as carpal tunnel syndrome can also affect those who have nonischemic cardiomyopathy brought on by amyloidosis. Other symptoms such as redness or swelling in the joints may be present in those with underlying inflammatory diseases.
How do doctors diagnose nonischemic cardiomyopathy?
To better understand your situation, your doctor will first ask you about your symptoms and medical history.
They will listen to your heart and lungs during a physical examination and check for any obvious symptoms of cardiomyopathy, such as swelling in your feet and legs.
Further testing could be ordered if they suspect cardiomyopathy. An echocardiography is one of the primary tests used by medical professionals to identify cardiomyopathy.
An ultrasound technique called an echocardiogram creates a real-time picture of the heart muscle during contraction and relaxation. It can assist your physician in determining how well your heart is working.
Further examinations for nonischemic cardiomyopathy may consist of:
- electrocardiogram
- chest X-ray or cardiac MRI
- blood tests
- stress test
- cardiac catheterization
What’s the treatment for nonischemic cardiomyopathy?
Treatment for nonischemic cardiomyopathy is based on the degree of heart damage, symptoms, and underlying aetiology.
Treating the underlying cause of nonischemic cardiomyopathy can be beneficial at times. If your issue is mild, your doctor may advise keeping an eye on it, changing your lifestyle, and implementing a heart-healthy diet.
Additionally, your doctor may prescribe medicine. The "four pillars" of heart failure therapy are one example of these:
renin-angiotensin inhibitors, such as:
- angiotensin-converting enzyme inhibitors
- angiotensin II receptor blockers
- angiotensin II receptor-neprilysin inhibitors
- beta-blockers
- mineralocorticoid antagonists
- sodium-glucose co-transporter 2 inhibitors
Extra drugs could consist of:
- diuretics to avoid edoema
- vasodilators that ease blood vessel tension
- To lower your heart rate, take ivabradine.
To control an erratic heartbeat, some people need a pacemaker or defibrillator surgically installed.
What’s the outlook for people with nonischemic cardiomyopathy?
Serious problems, including the following, can be more likely if you have nonischemic cardiomyopathy:
- heart failure
- sudden cardiac death
- ventricular arrhythmias
The aetiology of your nonischemic cardiomyopathy, as well as any medical disorders you may have and your degree of cardiac function, will all affect your prognosis.
Compared to ischemic cardiomyopathy, nonischemic cardiomyopathy typically has a better prognosis.
873 patients with cardiomyopathy were compared by the authors of a 2020 study. They found that ischemic cardiomyopathy patients had a greater death rate and a higher risk of sudden cardiac death than nonischemic cardiomyopathy patients.
Who’s at risk of nonischemic cardiomyopathy?
Nonischemic cardiomyopathy can affect anyone, but it primarily affects women and younger adults.
Among the significant risk factors are:
- hypertension
- a family history of cardiac arrest, cardiomyopathy, or heart failure
- certain medications
- cocaine and other stimulant drugs
- diabetes
- hemochromatosis
- obesity
- alcohol use disorder
- amyloidosis
- autoimmune conditions
- sarcoidosis
- thyroid disorders
- viral infections, such as COVID-19, influenza, herpes, or HIV
How can I prevent nonischemic cardiomyopathy?
It's possible that nonischemic cardiomyopathy cannot be prevented. The best you can do is take broad preventative measures, including frequent and thorough hand washing, to steer clear of common infections.
Prioritising heart health is also crucial. You could attempt:
- managing stress
- getting enough sleep
- limiting alcohol consumption
- eating a heart-healthy diet
- exercising regularly
To find out more about lifestyle modifications and heart-healthy habits, speak with a healthcare provider.
FAQs
The following are responses to some commonly asked issues concerning nonischemic cardiomyopathy.
How serious is non-ischemic cardiomyopathy?
Cardiomyopathy is a dangerous illness. In the absence of therapy, it may be fatal.
What is early nonischemic cardiomyopathy?
A broad spectrum of dilated, hypertrophic, and arrhythmogenic heart muscle abnormalities that are not explained by coronary artery disease, hypertension, valvular, or congenital heart disease are included in nonischemic cardiomyopathies.
Is ischemic cardiomyopathy heart failure?
Ischemic cardiomyopathy causes dilated ventricles, which show up as heart failure symptoms in decompensated individuals and a lower left ventricular ejection fraction on echocardiograms. Nevertheless, similar results can be mimicked by a wide range of other medical disorders.
Is it safe to exercise with nonischemic cardiomyopathy?
For the majority of patients with cardiomyopathy and heart failure, mild exercise daily is safe and can help control symptoms.
Takeaway
Any cardiomyopathy that isn't brought on by coronary artery disease is referred to as nonischemic cardiomyopathy.
Genetics may play a role. In other instances, it's connected to another ailment, such as an autoimmune disease or a viral infection.
When a doctor makes a diagnosis, they will look for the cause. Depending on what is causing your cardiomyopathy, your treatment may change.
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