MBBS (Singapore), MRCP (UK), MMed (Singapore)
What Is Cardiomyopathy and How Can It Affect Your Heart?
Cardiomyopathy refers to a group of conditions that affect the heart muscle. Depending on the type, the heart muscle may become enlarged, thickened or stiff, affecting how well the heart is able to function.
These changes can make it harder for the heart to pump or fill with blood effectively and, in some forms of cardiomyopathy, may also affect its rhythm.
What Are the Symptoms of Cardiomyopathy?
Some people with cardiomyopathy may have few or no noticeable symptoms, particularly in the early stages. When symptoms do develop, they can vary depending on how the condition is affecting the heart.
Possible symptoms include:
- Shortness of breath during activity or at rest
- Fatigue or weakness
- Swelling in the legs, ankles or feet
- Chest pain or discomfort
- Palpitations or awareness of an irregular heartbeat
- Lightheadedness or fainting
Symptoms may become more noticeable as the condition progresses, but their severity does not always indicate how significantly the heart has been affected.
What Are the Different Types of Cardiomyopathy?
Cardiomyopathy can affect the structure and function of the heart muscle in different ways. The type diagnosed depends on the changes occurring within the heart and, in some cases, the underlying cause.
Dilated Cardiomyopathy (DCM)
Dilated cardiomyopathy occurs when one or more chambers of the heart become enlarged and the heart muscle is unable to contract as effectively. It commonly affects the left ventricle, reducing the heart's ability to pump blood around the body.
Hypertrophic Cardiomyopathy (HCM)
Hypertrophic cardiomyopathy causes the heart muscle to become abnormally thickened, most commonly affecting the left ventricle. The thickened muscle can make it harder for the heart to relax and fill properly and, in some people, may obstruct blood leaving the heart.
Restrictive Cardiomyopathy (RCM)
Restrictive cardiomyopathy occurs when the heart muscle becomes stiff and cannot relax normally between beats. This can restrict how well the chambers fill with blood even when the heart's pumping ability is initially preserved.
Arrhythmogenic Cardiomyopathy
Arrhythmogenic cardiomyopathy is an inherited heart muscle disorder in which abnormal changes to the heart muscle can increase the risk of irregular heart rhythms (arrhythmias). It often affects the right ventricle but can also involve the left ventricle or both sides of the heart.
Takotsubo Cardiomyopathy
Takotsubo cardiomyopathy, sometimes called broken heart syndrome, causes a temporary change in how the heart muscle contracts. It can occur following significant emotional or physical stress and may cause symptoms similar to a heart attack, although the underlying mechanism is different.
What Can Cause Cardiomyopathy?
The cause of cardiomyopathy is not always known. Some forms are inherited, while others develop because of another condition or exposure that affects the heart muscle. In some people, more than one factor may be involved.
Genetic and Inherited Causes
Certain forms of cardiomyopathy can run in families because of genetic changes that affect the heart muscle. Hypertrophic cardiomyopathy and arrhythmogenic cardiomyopathy are among the types that may have an inherited basis.
A family history of cardiomyopathy or unexplained sudden cardiac death can therefore be relevant when assessing an individual's risk. Depending on the type of cardiomyopathy and family history, screening or genetic counselling may be considered.
Health Conditions That Can Affect the Heart Muscle
Cardiomyopathy can also develop in association with conditions that place strain on or directly damage the heart muscle. These may include:
- Long-standing high blood pressure, which can cause changes in the structure of the heart
- Coronary artery disease or a previous heart attack, which can damage areas of heart muscle
- Myocarditis, where inflammation of the heart muscle may affect its function
- Certain metabolic or systemic conditions that can affect the heart over time
Other Factors That Can Damage the Heart Muscle
Other exposures or circumstances can contribute to cardiomyopathy in some people. These include prolonged excessive alcohol consumption and certain medications or treatments that can damage the heart muscle.
Some chemotherapy drugs, for example, can have cardiotoxic effects and may require monitoring of heart function during or after treatment. Nutritional deficiencies can also contribute to heart muscle dysfunction in certain circumstances, although this is less common.
How Is Cardiomyopathy Diagnosed?
Diagnosing cardiomyopathy involves assessing how the heart is structured and functioning while looking for clues about what may be causing the changes. Your doctor may ask about your symptoms and family history before recommending tests based on the findings.
Tests used to investigate suspected cardiomyopathy may include:
- Electrocardiogram (ECG): Records the heart's electrical activity and can identify abnormal rhythms or other changes.
- Echocardiogram: Uses ultrasound to assess the heart muscle, chamber size and how effectively the heart is pumping.
- Blood tests: May help identify conditions that could be contributing to symptoms or changes in heart function.
- Cardiac MRI: Provides detailed images of the heart and can help assess the heart muscle where further information is needed.
- Genetic testing: May be considered when an inherited form of cardiomyopathy is suspected, particularly where there is a relevant family history.
How Is Cardiomyopathy Treated?
Treatment for cardiomyopathy depends on the type of condition and how it is affecting the heart. Some people may require ongoing monitoring, while others need treatment to manage symptoms or reduce the risk of complications.
Medications
Different medications may be prescribed depending on the effects of cardiomyopathy. These may include:
- Heart failure medications: May be used to support heart function and manage symptoms when the heart's pumping ability is reduced.
- Diuretics: Help the body remove excess fluid and may ease symptoms caused by fluid build-up.
- Medications for abnormal heart rhythms: May be prescribed when cardiomyopathy is associated with an arrhythmia.
- Anticoagulants: May be recommended for some patients who have an increased risk of developing blood clots.
Implantable Devices
Some people may require a device to help manage abnormal heart rhythms or support the heart's function. Depending on the condition, options may include:
- Implantable cardioverter-defibrillator (ICD): Monitors the heart rhythm and can deliver treatment when certain dangerous abnormal rhythms occur.
- Pacemaker: Helps regulate the heartbeat when there is a problem with the heart's electrical conduction or rhythm.
- Cardiac resynchronisation therapy (CRT): Uses a specialised pacemaker to help the heart's chambers contract in a more coordinated way in selected patients with heart failure.
Procedures and Surgery
Procedural or surgical treatment may be considered for certain forms of cardiomyopathy or when the condition has become severe despite other treatment.
- Septal reduction treatment: May be considered for selected patients with obstructive hypertrophic cardiomyopathy when symptoms remain significant despite medical treatment. This can include surgical septal myectomy or, in suitable patients, alcohol septal ablation.
- Left ventricular assist device (LVAD): A mechanical pump that may be used in selected patients with advanced heart failure to support circulation.
- Heart transplantation: May be considered for severe, advanced heart failure when other treatment options are no longer sufficient.
Managing Cardiomyopathy With Dr Ang Teck Kee
Cardiomyopathy may require ongoing follow-up to monitor changes in heart function and determine
whether management needs to be adjusted over time. The type and frequency of follow-up will depend
on the condition and how it is affecting the heart.
At Ace Cardiology Clinic, Dr Ang Teck Kee assesses patients with suspected
or diagnosed heart conditions and advises on appropriate management based on their clinical
findings. Where cardiomyopathy is suspected, further cardiac investigations can help establish how
the heart has been affected and guide the next steps in care.
If you have ongoing symptoms or concerns about your heart health, schedule a consultation for further assessment.
Frequently Asked Questions (FAQs) About Managing Cardiomyopathy in Singapore
Can cardiomyopathy affect pregnancy?
Can I exercise if I have cardiomyopathy?
Should family members be screened if I have cardiomyopathy?
Meet Our Doctor
Dr Ang Teck Kee
Cardiologist
M.B.B.S (Singapore), MRCP (UK), M.Med (Singapore)
Dr Ang Teck Kee is a dedicated cardiologist with 20 years of experience in interventional cardiology. He has performed over 3,000 invasive coronary angiographies and percutaneous coronary interventions. Dr Ang takes a patient-centred approach, creating personalised treatment plans tailored to each individual's needs. His commitment extends beyond the clinic, as he actively contributes to medical research, serving as a co-investigator in numerous international and local clinical trials.
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3 Mount Elizabeth, #17-18
Mount Elizabeth Medical Centre
Singapore 228510
Mon to Fri: 9:00am–5:00pm
Sat: 9:00am-12:00pm
Sun & PH: Closed
Tel: 6235 7536 | 9155 2942
Fax: 6235 7598
info@acecardiologyclinic.com
Need Help or Make an Appointment.
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So please call us at +65 9155 2942. We look forward to hearing from you.
