Cardiomyopathy is a disease of the heart muscle, which causes it to become weakened and unable to pump blood effectively. Cardiomyopathy is a major cause of heart failure and one of the most common conditions leading to heart transplantation.
There are three types of cardiomyopathy:
- In dilated cardiomyopathy, the left ventricle becomes enlarged and does not pump as efficiently.
- In hypertrophic cardiomyopathy the heart muscle is abnormally thick, affecting the heart's ability to pump blood.
- In restrictive cardiomyopathy the heart becomes rigid and can't properly fill with blood between heartbeats.
The Cardiovascular Center at BMC offers expertise in medical and interventional treatment for cardiomyopathy/heart failure. Our specialized team coordinates the evaluation and care for patients with this condition. Working with primary care physicians and community-based cardiologists, the team offers a wide range of options, including new pharmacologic and surgical treatments. Through comprehensive, long-term management, the goal is to minimize the frequency and impact of complications to maximize each patient’s productivity and quality of life.
Diagnosis and Evaluation
The diagnosis and evaluation of suspected cardiomyopathy typically starts with a consultation with a heart failure specialist, and includes a detailed history and physical examination, as well as an electrocardiogram, chest X-ray and blood tests. In most cases the next step involves a non-invasive assessment of heart size and function, typically by echocardiography, and in some cases by nuclear magnetic resonance (NMR) imaging. Additional studies that may provide important information include an exercise stress test and/or nuclear scans of the heart. In some cases further invasive studies may be helpful including cardiac catheterization and electrophysiologic evaluation.
Once the cause of heart failure in a patient is determined, a customized medical treatment program is designed based on guideline-validated therapies. If correctable causes are identified, there may be specific treatment to treat hypertension or address coronary artery or valvular disease. Typical medical therapy includes a diuretic (medication to control fluid accumulation and a beta-blocker (a medication to reduce blood pressure). In some cases additional drugs may be indicated or preferred.
The CVC program is involved in the discovery and development of new therapies for cardiomyopathy and heart failure. Boston University School of Medicine played a key role in the development of current day standard therapies including beta-blockers, angiotensin converting enzyme inhibitors and aldosterone antagonists. BMC has access to novel investigational therapies, often years before they are available on the market, and are able to use these agents in selected patients who meet the criteria for their use.
Implantable Cardiac Defibrillators (ICDs) and Cardiac Resynchronization Therapy (CRT)
The Cardiomyopathy Team works closely with the Electrophysiology Team to determine the need for devices that can decrease the risk abnormal cardiac rhythms (ICDs) and/or to improve the synchronization of the walls of the heart (CRTs). These devices can be life-saving and lead to improved outcomes in many patients with cardiomyopathy.