Topic: Cardiomyopathy
Question: What are the treatments for Cardiomyopathy ?
Answer: People who have cardiomyopathy but no signs or 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 needed. Treatment depends on the type of cardiomyopathy you have, the severity of your symptoms and complications, and your age and overall health. Treatments may include:
                
Heart-healthy lifestyle changes
                
Medicines
                
Nonsurgical procedure
                
Surgery and implanted devices
                
The main goals of treating cardiomyopathy include:
                
Controlling signs and symptoms so that you 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
                
Heart-Healthy Lifestyle Changes
                
Your doctor may suggest lifestyle changes to manage a condition thats causing your cardiomyopathy including:
                
Heart-healthy eating
                
Maintaining a healthy weight
                
Managing stress
                
Physical activity
                
Quitting smoking
                
Heart-Healthy Eating
                
Your doctor may recommend heart-healthy eating, which should include:
                
Fat-free or low-fat dairy products, such as fat-free milk
                
Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week
                
Fruits, such as apples, bananas, oranges, pears, and prunes
                
Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans
                
Vegetables, such as broccoli, cabbage, and carrots
                
Whole grains, such as oatmeal, brown rice, and corn tortillas
                
When following a heart-healthy diet, you should avoid eating:
                
A lot of red meat
                
Palm and coconut oils
                
Sugary foods and beverages
                
Two nutrients in your diet make blood cholesterol levels rise:
                
Saturated fatfound mostly in foods that come from animals
                
Trans fat (trans fatty acids)found in foods made with hydrogenated oils and fats such as stick margarine;baked goods such as, cookies, cakes, and pies, crackers, frostings, and coffee creamers. Some trans fats also occur naturally in animal fats and meats.
                
Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples:
                
Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels.
                
Some sources of monounsaturated and polyunsaturated fats are:
                
Avocados
                
Corn, sunflower, and soybean oils
                
Nuts and seeds, such as walnuts
                
Olive, canola, peanut, safflower, and sesame oils
                
Peanut butter
                
Salmon and trout
                
Tofu
                
Sodium
                
Try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and no added salt foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more.
                
Dietary Approaches to Stop Hypertension
                
Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt.
                
The DASH eating plan is a good heart-healthy eating plan, even for those who dont have high blood pressure. Read more about DASH.
                
Alcohol
                
Talk to your doctor about how much alcohol you drink. Too much alcohol canraise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain. Your doctor may recommend that you reduce the amount of alcohol you drinkor stop drinking alcohol.
                

                
Maintaining a Healthy Weight
                
Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active.
                
Knowing your body mass index (BMI) helps you find out if youre a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institutes (NHLBI) onlineBMI calculatoror talk to your doctor.A BMI:
                
Below 18.5 is a sign that you are underweight.
                
Between 18.5 and 24.9 is in the normal range.
                
Between 25 and 29.9 is considered overweight.
                
Of 30 or more is considered obese.
                
A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal.
                
Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, youre at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visitAssessing Your Weight and Health Risk.
                
If youre overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol.
                

                
Managing Stress
                
Research shows that the most commonly reported trigger for a heart attack is an emotionally upsetting eventparticularly one involving anger. Also, some of the ways people cope with stresssuch as drinking, smoking, or overeatingarent healthy.
                
Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.Consider healthy stress-reducing activities, such as:
                
A stress management program
                
Meditation
                
Physical activity
                
Relaxation therapy
                
Talking things out with friends or family
                

                
Physical Activity
                
Routine physical activity can lower many risk factors for coronary heart disease, including LDL (bad) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. HDL is the good cholesterol that helps prevent coronary heart disease.
                
Everyone should try to participate in moderate intensity aerobic exercise at least 2hours and 30minutes per week, or vigorous intensity aerobic exercise for 1hour and 15minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats fasterand you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week.
                
Read more about physical activity at:
                
Physical Activity and Your Heart
                
U.S. Department of Health and Human Services 2008 Physical Activity Guidelines forAmericans
                
Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you.
                

                
Quitting Smoking
                
If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.
                
If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.
                
Read more about quitting smoking at Smoking and Your Heart.
                

                
Medicines
                
Many medicines are used to treat cardiomyopathy. Your doctor may prescribe medicines to:
                
Balance electrolytes in your body. Electrolytes are minerals that help maintain fluid levels and acid-base balance in the body. They also help muscle and nerve tissues work properly. Abnormal electrolyte levels may be a sign of dehydration (lack of fluid in your body), heart failure, high blood pressure, or other disorders. Aldosterone blockers are an example of a medicine used to balance electrolytes.
                
Keep your heart beating with a normal rhythm. These medicines, called antiarrhythmics, help prevent arrhythmias.
                
Lower your blood pressure. ACE inhibitors, angiotensin II receptor blockers, beta blockers, and calcium channel blockers are examples of medicines that lower blood pressure.
                
Prevent blood clots from forming. Anticoagulants, or blood thinners, are an example of a medicine that prevents blood clots. Blood thinners often are used to prevent blood clots from forming in people who have dilated cardiomyopathy.
                
Reduce inflammation. Corticosteroids are an example of a medicine used to reduce inflammation.
                
Remove excess sodium from your body. Diuretics, or water pills, are an example of medicines that help remove excess sodium from the body, which reduces the amount of fluid in your blood.
                
Slow your heart rate. Beta blockers, calcium channel blockers, and digoxin are examples of medicines that slow the heart rate. Beta blockers and calcium channel blockers also are used to lower blood pressure.
                
Take all medicines regularly, as your doctor prescribes. Dont change the amount of your medicine or skip a dose unless your doctor tells you to.
                
Surgery and Implanted Devices
                
Doctors use several types of surgery to treat cardiomyopathy, including septal myectomy, surgically implanted devices, and heart transplant.
                
Septal Myectomy
                
Septal myectomy is open-heart surgery and is used to treat people who have hypertrophic cardiomyopathy and severe symptoms. This surgery generally is used for younger patients and for people whose medicines arent working well.
                
A surgeon removes part of the thickened septum thats bulging into the left ventricle. This improves blood flow through the heart and out to the body. The removed tissue doesnt grow back. If needed, the surgeon also can repair or replace the mitral valve at the same time. Septal myectomy often is successful and allows you to return to a normal life with nosymptoms.
                
Surgically Implanted Devices
                
Surgeons can place several types of devices in the heart to improve function and symptoms, including:
                
Cardiac resynchronization therapy (CRT) device. A CRT device coordinates contractions between the hearts left and right ventricles.
                
Implantable cardioverter defibrillator(ICD). An ICD helps control life-threatening arrhythmias that may lead tosudden cardiac arrest. This small device is implanted in the chest or abdomen and connected to the heart with wires. If an ICD senses a dangerous change in heart rhythm, it will send an electric shock to the heart to restore a normal heartbeat.
                
Left ventricular assist device (LVAD). This device helps the heart pump blood to the body. An LVAD can be used as a long-term therapy or as a short-term treatment for people who are waiting for a heart transplant.
                
Pacemaker. This small device is placed under the skin of your chest or abdomen to help control arrhythmias. The device uses electrical pulses to prompt the heart to beat at a normal rate.
                
Heart Transplant
                
For this surgery, a surgeon replaces a persons diseased heart with a healthy heart from a deceased donor. A heart transplant is a last resort treatment for people who have end-stage heart failure. End-stage means the condition has become so severe that all treatments, other than heart transplant, have failed. For more information about this treatment, go to the Heart Transplant Health Topic.
                
Nonsurgical Procedure
                
Doctors may use a nonsurgical procedure called alcohol septal ablation to treat cardiomyopathy. During this procedure, the doctor injects ethanol (a type of alcohol) through a tube into the small artery that supplies blood to the thickened area of heart muscle. The alcohol kills cells, and the thickened tissue shrinks to a more normal size. This procedure allows blood to flow freely through the ventricle, which improves symptoms.
(Source: NHLBI)