Cardiomyopathies are primary non-inflammatory myocardial lesions of unknown cause that are not associated with valvular insufficiency or congenital heart disease, coronary heart disease, arterial or pulmonary hypertension, or systemic diseases. The mechanism of development of cardiomyopathies is unclear. Perhaps the participation of genetic factors, violations of the hormonal regulation of the body. The possible impact of a viral infection and changes in the immune system cannot be ruled out.
Hypertrophic cardiomyopathy. Non-obstructive (not causing difficulties for the movement of blood inside the heart) is characterized by an increase in the size of the heart due to thickening of the walls of the left ventricle, less often only the apex of the heart. Noise may be heard. With hypertrophy of the interventricular septum with narrowing of the outflow of blood from the left ventricle (obstructive form), chest pains, dizziness attacks with a tendency to fainting, paroxysmal nocturnal shortness of breath, loud systolic murmur appear. Arrhythmias and intracardiac conduction disturbances (blockades) are not uncommon.
The progression of cardiomyopathies leads to the development of heart failure. The electrocardiogram reveals signs of left ventricular hypertrophy, sometimes changes resemble those of myocardial infarction (“infarction-like” ECG).
Congestive (dilated) cardiomyopathy is manifested by a sharp expansion of all chambers of the heart in combination with their non-cordial hypertrophy and steadily progressing, untreatable heart failure, the development of thrombosis and thromboembolism. The prognosis for progressive heart failure is poor. At the expressed forms cases of sudden death are observed.
Treatment. In case of hypertrophic cardiopathy, beta-blockers (anaprilin, obzidan, inderal) are used, in case of violation of the ways of outflow of blood from the heart, a surgical method is possible. With the development of heart failure, physical activity, salt and fluid intake are limited, peripheral vasodilators (nitrates, capoten, prazosin, depression, molsidomine), diuretics, calcium antagonists (isoptin, verapamil) are used. Cardiac glycosides are practically ineffective. With congestive cardiopathy, a heart transplant is possible.