What is cardiopathy?

The human heart is a pump that pumps blood from its cavities into the vessels, delivering oxygen and nutrients to all organs, any disturbances in its structure lead to serious consequences, an example is cardiopathy - what is it? In adults, this term refers to secondary myocardial lesions from various causes; in children, the pathology is more often congenital.

It is based on metabolic disorders in cardiomyocytes, leading over time to an increase in the size of the heart and a decrease in its contractile function.

Causes and mechanisms

Primary myocardial damage is idiopathic (no known cause) or congenital, in the latter case, the symptoms of the disease are detected already in early childhood, treatment is carried out by medical or surgical methods.

It has been established that certain genetic mutations lead to impaired contractile protein synthesis in the myocardium, which contributes to the formation of structural changes in the walls of the heart.

Depending on the mechanism of development, several types of myocardial damage are distinguished:

1. Dilated cardiomyopathy is the most common and severe form of the disease, characterized by stretching of the walls of the heart cavities (mainly the ventricles). The causes of development are often Coxsackie enteroviruses and alcohol abuse, the treatment consists only in a heart transplant.
2. Hypertrophic cardiomyopathy is one of the main causes of sudden death in young people (mainly athletes). It is characterized by thickening of the walls of the heart and the impossibility of a full transmission of electrical impulses. Symptoms may be absent for a long time. It is based on gene mutations, conservative and surgical treatment.
3. The restrictive form is a rare pathology in which the diastolic volume of the ventricles is sharply reduced with a constant thickness of the myocardium.

Secondary cardiopathy is always a consequence of another pathology in adults and adolescents.

Depending on the predominant etiological factor, the types of CMP are distinguished:

• functional - characteristic of adolescents and is associated with the maturation of the autonomic innervation of the heart;
• dishormonal - occurs when there is an imbalance of hormones in women during menopause (a decrease in the protective background of estrogen), it may be in adolescents against the background of the formation of hormonal levels;
• dysmetabolic - with metabolic disorders (pathology of the thyroid gland, diabetes);
• ischemic - occurs against the background of coronary artery disease, atherosclerotic disease;
• toxic form - associated with a direct effect on the heart muscle of ethanol, poisons and toxins, symptoms appear in alcohol lovers with a long history of drinking;
• autoimmune - develops with a decrease in immunity after past illnesses with the production of antibodies against one's own cardiomyocytes.

Symptoms

Unfortunately, for quite a long time, cardiomyopathy can be asymptomatic, then nonspecific signs appear:

• shortness of breath on exertion;
• pain in the region of the heart in the form of tingling, compression;
• increased fatigue;
• a feeling of rapid heartbeat in the chest, "tumbling" or "fading", associated with a violation of the heart rhythm.

These symptoms cannot reliably testify in favor of the diagnosis of cardiomyopathy; they occur in other diseases, including those provoking the occurrence of cardiopathy.

The patient has the following symptoms:

• pronounced swelling in the legs, especially in the evening, due to the release of the liquid part of the blood from the vessels into the intercellular space due to slow blood flow with low contractile function of the myocardium;
• damage to the skin (cracks with weeping) due to severe edema;
• ascites (accumulation of fluid in the abdominal cavity);
• liver enlargement;
• atrial fibrillation;
• persistent cough, especially when lying down, due to pulmonary edema;
• severe shortness of breath at rest;
• acrocyanosis - bluish coloration of the tip of the nose, fingers and lips (symptoms of venous blood stasis).

Such symptoms do not raise doubts about the presence of heart failure. It happens that only during this period, patients seek help from a specialist. Accurate diagnosis of the disease, determination of the cause and degree of pathological changes in the structures of the heart are determined using additional research methods - ECG, echocardiography, X-ray, MRI or other examinations according to indications.

Treatment

The types of treatment are:

1. Etiotropic and pathogenetic treatment is prescribed for a clear cause of CMP (diabetes, thyrotoxicosis, alcoholism, menopause). In these cases, measures to normalize the hormonal background, correct blood sugar and metabolic disorders, or other appointments made by the relevant specialists come to the fore.
2. It is impossible to do anything with hereditary forms of cardiomyopathy (for example, genetic dilated cardiopathy), the only way out is a radical treatment - a heart transplant.
3. In the absence of indications of the cause of the development of the pathology, the existing symptoms are eliminated. Such treatment is called symptomatic, it is carried out to alleviate the patient's condition and improve his quality of life. The drugs of choice for severe cardiac arrhythmias are beta-blockers (Bisoprolol and analogues) - they reduce the frequency and strength of heart contractions, improve blood supply to the heart, relax vascular smooth muscles, and stop shortness of breath. The complex of measures uses diuretics, antianginal drugs, drugs that improve metabolism in the heart muscle (Preductal), ACE inhibitors and calcium channel antagonists.
4. Surgical treatment is used in the hypertrophic form of CMP (removal of excess muscle tissue) quite successfully. The modern method is to implant a small defibrillator under the skin of the patient, which works a few seconds after cardiac arrest and gives the patient a chance to prolong life.

The prognosis for cardiomyopathy is generally unfavorable, especially with the development of complications such as atrial fibrillation and heart failure. With hypertrophic and dilated cardiomyopathy, the likelihood of sudden death is high. Prevention consists in obligatory dispensary observation of patients from families with hereditary cardiomyopathies. When suspicious symptoms appear, treatment should begin as soon as possible.