Heart Failure Support Group
Heart failure is a condition that can result from any structural or functional cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood throughout the body. It is often undiagnosed due to a lack of a universally agreed definition and difficulties in diagnosis, particularly when the condition is considered "mild."
Hi,
I got together the information on my type of heart disease. Getting this disease was such a shock. I was in my prime. My children were graduating high school and going to college and I was doing well in my profession. My husband was a "pain" at that time thought. I think he was just going through some sort of issue with the kids growing up. Oh well!
Here it is....
Section
Heart and Blood Vessel Disorders
Subject
Cardiomyopathy
Dilated Cardiomyopathy
Dilated (congestive) cardiomyopathy is a group of heart muscle disorders in which the ventricles enlarge but are not able to pump enough blood for the body's needs, resulting in heart failure.
Coronary artery disease, viral infections, and some hormonal disorders are common causes of dilated cardiomyopathy.
Shortness of breath and fatigue are often the first symptoms.
Electrocardiography and echocardiography are used to diagnose dilated cardiomyopathy.
Doctors try to treat the cause of dilated cardiomyopathy, usually by giving drugs.
Dilated cardiomyopathy can develop at any age but is more common among people aged 20 to 60 years. About 10% of people who develop dilated cardiomyopathy are older than 65. The disorder occurs in about 3 times as many men as women and 3 times as many blacks as whites. About 5 to 8 of every 100,000 people develop the disorder each year.
Causes
In North America, the most common identifiable cause of dilated cardiomyopathy is extensive coronary artery disease. Such coronary artery disease results in an inadequate blood supply to the heart muscle, which leads to permanent injury and death of heart muscle. As a result, the heart cannot pump as forcefully. The dead heart muscle is replaced by fibrous (scar) tissue. The remaining uninjured heart muscle then stretches and thickens (hypertrophies) to compensate for the lost pumping action. The more the heart muscle is stretched, the more forcefully it contracts or pumps but only up to a point. After that point, the stretching and thickening do not adequately compensate, and dilated cardiomyopathy with heart failure develops.
Dilated cardiomyopathy also may be caused by an acute inflammation of the heart muscle (myocarditis) due to a viral infection. This disorder is called viral cardiomyopathy. In North America, infection with coxsackie B virus is the most common cause of viral cardiomyopathy. In other parts of the world, other viral infections are more common causes. The virus infects and weakens the heart muscle. As in coronary artery disease, the weakened heart stretches in an attempt to compensate, resulting in dilated cardiomyopathy and often heart failure. Occasionally, dilated cardiomyopathy results from a bacterial infection.
Other causes of dilated cardiomyopathy include certain chronic hormonal disorders such as long-standing, poorly controlled diabetes, morbid obesity, a persistently rapid heart rate, or thyroid disease. Dilated cardiomyopathy also can be caused by use of certain substances, especially alcohol (when intake is heavy and malnutrition is also present), cocaine, antidepressants, and a few chemotherapy drugs. Rare causes of dilated cardiomyopathy include pregnancy and connective tissue disorders such as rheumatoid arthritis. When no specific cause can be identified, the disorder is called an idiopathic dilated cardiomyopathy.
Symptoms
Usually, the first symptoms of dilated cardiomyopathy are becoming short of breath during exertion and tiring easily. They result from a weakening of the heart's pumping action, which is called heart failure (see Heart Failure). When cardiomyopathy results from an infection, the first symptoms may be a sudden fever and flu-like symptoms. Whatever the cause of dilated cardiomyopathy, if the heart damage is severe enough, the heart rate eventually speeds up, blood pressure is normal or low, fluid is retained in the legs and abdomen, and the lungs fill with fluid.
Because the heart is enlarged, the heart valves may be unable to close normally and often leak. The valves most often affected are the mitral valve, which is positioned between the left atrium (upper heart chamber) and the left ventricle (lower heart chamber), and the tricuspid valve, which is positioned between the right atrium and the right ventricle. Leakage causes murmurs, which doctors can hear with a stethoscope. Damage to and stretching of the heart muscle may result in abnormal heart rhythms (arrhythmias), which may cause awareness of heartbeats (palpitations) or death. The leakage of the valves and the abnormal heart rhythms may interfere further with the heart's pumping action.
Blood pools in the enlarged heart, increasing the risk of blood clots forming on heart chamber walls. The clots can break into pieces (becoming emboli), travel from the heart to blood vessels elsewhere in the body, and block them, causing damage to the organ they supply. If the blood supply to the brain is blocked, a stroke can result.
Diagnosis
The diagnosis is based on the symptoms and the results of a physical examination. Electrocardiography (ECG) may detect abnormalities in the electrical activity of the heart. However, these abnormalities are usually not sufficient evidence for a diagnosis. Echocardiography which uses ultrasound waves to produce an image of the heart, is the most useful procedure because it can show the size and pumping action of the heart. Magnetic resonance imaging (MRI), which produces very detailed images of the heart, may be used to confirm the diagnosis (and sometimes identify the cause).
If the diagnosis remains in doubt, cardiac catheterization, an invasive procedure in which a catheter is threaded into the heart, can provide additional information about the pumping ability of the heart. During cardiac catheterization, doctors can also measure pressures in the heart chambers and determine the extent of coronary artery disease. During catheterization, doctors sometimes remove a tissue sample for examination under a microscope (biopsy). A biopsy can sometimes identify the characteristic microscopic changes of some disorders that cause dilated cardiomyopathy (such as a viral infection that has just developed) and thus confirm the diagnosis. However, usually, the results of a biopsy are not specific enough to help with the diagnosis.
Prognosis
About 70% of people die within 5 years of when their symptoms begin, and the prognosis worsens as the heart becomes more dilated and functions less well. Abnormal heart rhythms also indicate a worse prognosis. Overall, men survive only half as long as women, and blacks survive half as long as whites. About 50% of deaths are sudden, probably resulting from an abnormal heart rhythm.
Treatment
If possible, doctors treat the underlying cause.
General treatment measures include avoiding stress, limiting salt in the diet, and having periods of rest, which help reduce strain on the heart, particularly when the cardiomyopathy is acute or severe.
Drugs, such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, beta-blockers, spironolactone or eplerenone, and low-dose digoxin, improve the heart's pumping function, prolong life, and decrease persistent symptoms. Diuretics are used to reduce excess fluid in the lungs and decrease symptoms of swelling due to fluid retention, but they do not prolong life.
Antiarrhythmic drugs may be given to prevent abnormal heart rhythms. Most of these drugs are prescribed in small doses. Doses are increased in small increments, because if the dose is too large, an antiarrhythmic drug may worsen heart rhythm abnormalities or depress pumping function. Some people have an abnormality of the electrical conduction in the heart, which can be helped by a pacemaker. Doctors may consider an implantable cardioverter-defibrillator pacemaker in patients with persistent poor heart function and an increased risk of sudden death.
Regardless of the cause of dilated cardiomyopathy, doctors may give anticoagulants, such as warfarin, to prevent blood clots, which may form on the heart chamber walls of very dilated and poorly contracting ventricles.
Unless a specific cause of dilated cardiomyopathy can be treated, heart failure in dilated cardiomyopathy is often fatal. Because of this poor prognosis, dilated cardiomyopathy is the most common reason for heart transplantation (see Transplantation: Heart Transplantation). Successful heart transplantation cures the disorder, but it has its own complications and limitations.
I got together the information on my type of heart disease. Getting this disease was such a shock. I was in my prime. My children were graduating high school and going to college and I was doing well in my profession. My husband was a "pain" at that time thought. I think he was just going through some sort of issue with the kids growing up. Oh well!
Here it is....
Section
Heart and Blood Vessel Disorders
Subject
Cardiomyopathy
Dilated Cardiomyopathy
Dilated (congestive) cardiomyopathy is a group of heart muscle disorders in which the ventricles enlarge but are not able to pump enough blood for the body's needs, resulting in heart failure.
Coronary artery disease, viral infections, and some hormonal disorders are common causes of dilated cardiomyopathy.
Shortness of breath and fatigue are often the first symptoms.
Electrocardiography and echocardiography are used to diagnose dilated cardiomyopathy.
Doctors try to treat the cause of dilated cardiomyopathy, usually by giving drugs.
Dilated cardiomyopathy can develop at any age but is more common among people aged 20 to 60 years. About 10% of people who develop dilated cardiomyopathy are older than 65. The disorder occurs in about 3 times as many men as women and 3 times as many blacks as whites. About 5 to 8 of every 100,000 people develop the disorder each year.
Causes
In North America, the most common identifiable cause of dilated cardiomyopathy is extensive coronary artery disease. Such coronary artery disease results in an inadequate blood supply to the heart muscle, which leads to permanent injury and death of heart muscle. As a result, the heart cannot pump as forcefully. The dead heart muscle is replaced by fibrous (scar) tissue. The remaining uninjured heart muscle then stretches and thickens (hypertrophies) to compensate for the lost pumping action. The more the heart muscle is stretched, the more forcefully it contracts or pumps but only up to a point. After that point, the stretching and thickening do not adequately compensate, and dilated cardiomyopathy with heart failure develops.
Dilated cardiomyopathy also may be caused by an acute inflammation of the heart muscle (myocarditis) due to a viral infection. This disorder is called viral cardiomyopathy. In North America, infection with coxsackie B virus is the most common cause of viral cardiomyopathy. In other parts of the world, other viral infections are more common causes. The virus infects and weakens the heart muscle. As in coronary artery disease, the weakened heart stretches in an attempt to compensate, resulting in dilated cardiomyopathy and often heart failure. Occasionally, dilated cardiomyopathy results from a bacterial infection.
Other causes of dilated cardiomyopathy include certain chronic hormonal disorders such as long-standing, poorly controlled diabetes, morbid obesity, a persistently rapid heart rate, or thyroid disease. Dilated cardiomyopathy also can be caused by use of certain substances, especially alcohol (when intake is heavy and malnutrition is also present), cocaine, antidepressants, and a few chemotherapy drugs. Rare causes of dilated cardiomyopathy include pregnancy and connective tissue disorders such as rheumatoid arthritis. When no specific cause can be identified, the disorder is called an idiopathic dilated cardiomyopathy.
Symptoms
Usually, the first symptoms of dilated cardiomyopathy are becoming short of breath during exertion and tiring easily. They result from a weakening of the heart's pumping action, which is called heart failure (see Heart Failure). When cardiomyopathy results from an infection, the first symptoms may be a sudden fever and flu-like symptoms. Whatever the cause of dilated cardiomyopathy, if the heart damage is severe enough, the heart rate eventually speeds up, blood pressure is normal or low, fluid is retained in the legs and abdomen, and the lungs fill with fluid.
Because the heart is enlarged, the heart valves may be unable to close normally and often leak. The valves most often affected are the mitral valve, which is positioned between the left atrium (upper heart chamber) and the left ventricle (lower heart chamber), and the tricuspid valve, which is positioned between the right atrium and the right ventricle. Leakage causes murmurs, which doctors can hear with a stethoscope. Damage to and stretching of the heart muscle may result in abnormal heart rhythms (arrhythmias), which may cause awareness of heartbeats (palpitations) or death. The leakage of the valves and the abnormal heart rhythms may interfere further with the heart's pumping action.
Blood pools in the enlarged heart, increasing the risk of blood clots forming on heart chamber walls. The clots can break into pieces (becoming emboli), travel from the heart to blood vessels elsewhere in the body, and block them, causing damage to the organ they supply. If the blood supply to the brain is blocked, a stroke can result.
Diagnosis
The diagnosis is based on the symptoms and the results of a physical examination. Electrocardiography (ECG) may detect abnormalities in the electrical activity of the heart. However, these abnormalities are usually not sufficient evidence for a diagnosis. Echocardiography which uses ultrasound waves to produce an image of the heart, is the most useful procedure because it can show the size and pumping action of the heart. Magnetic resonance imaging (MRI), which produces very detailed images of the heart, may be used to confirm the diagnosis (and sometimes identify the cause).
If the diagnosis remains in doubt, cardiac catheterization, an invasive procedure in which a catheter is threaded into the heart, can provide additional information about the pumping ability of the heart. During cardiac catheterization, doctors can also measure pressures in the heart chambers and determine the extent of coronary artery disease. During catheterization, doctors sometimes remove a tissue sample for examination under a microscope (biopsy). A biopsy can sometimes identify the characteristic microscopic changes of some disorders that cause dilated cardiomyopathy (such as a viral infection that has just developed) and thus confirm the diagnosis. However, usually, the results of a biopsy are not specific enough to help with the diagnosis.
Prognosis
About 70% of people die within 5 years of when their symptoms begin, and the prognosis worsens as the heart becomes more dilated and functions less well. Abnormal heart rhythms also indicate a worse prognosis. Overall, men survive only half as long as women, and blacks survive half as long as whites. About 50% of deaths are sudden, probably resulting from an abnormal heart rhythm.
Treatment
If possible, doctors treat the underlying cause.
General treatment measures include avoiding stress, limiting salt in the diet, and having periods of rest, which help reduce strain on the heart, particularly when the cardiomyopathy is acute or severe.
Drugs, such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, beta-blockers, spironolactone or eplerenone, and low-dose digoxin, improve the heart's pumping function, prolong life, and decrease persistent symptoms. Diuretics are used to reduce excess fluid in the lungs and decrease symptoms of swelling due to fluid retention, but they do not prolong life.
Antiarrhythmic drugs may be given to prevent abnormal heart rhythms. Most of these drugs are prescribed in small doses. Doses are increased in small increments, because if the dose is too large, an antiarrhythmic drug may worsen heart rhythm abnormalities or depress pumping function. Some people have an abnormality of the electrical conduction in the heart, which can be helped by a pacemaker. Doctors may consider an implantable cardioverter-defibrillator pacemaker in patients with persistent poor heart function and an increased risk of sudden death.
Regardless of the cause of dilated cardiomyopathy, doctors may give anticoagulants, such as warfarin, to prevent blood clots, which may form on the heart chamber walls of very dilated and poorly contracting ventricles.
Unless a specific cause of dilated cardiomyopathy can be treated, heart failure in dilated cardiomyopathy is often fatal. Because of this poor prognosis, dilated cardiomyopathy is the most common reason for heart transplantation (see Transplantation: Heart Transplantation). Successful heart transplantation cures the disorder, but it has its own complications and limitations.
Guess I'll have to wait and see!
Thanks. Informative post you have there.
What are your references? I'd like to check them because that 70% in 5 years thing sounds really bad. I'm only 25. It sounds crazy to think I could be dead of heart failure by age 30!
My doctor told my husband 10 years for me. It has been almost 4 years since my heart failure. You better believe I want to go longer that 10 years and I plan on it. The main thing is to make your life count right now and plan for the future. My doctor also said because this is a fairly common disease there is a plethora of information and research in the area. This gives me hope that new treatments will become available. Thank you for your comment.
Shelly
BUT...I refuse to let this be a death sentence..because i took my doctor and a nurse's advice to heart i have had improvements to all my heart functions..I have to continue mild daily exercise, i restrict sodium to about 500-1000 mg daily or less if i can...and i take all my meds...i do not work..i was granted SS disability...and i avoid stress and exertion..i know i could have sudden cardiac arrest...as could anyone with heart problems...but i am doing ALL that i can to not be part of that high percentage of mortality...i had to give up career plans, family plans, and re-think all my short and long terms plans...my husband and my kids are the most important things to me now and work to enjoy every moment that i have...and i am so thankful that i did not have this heart failure years ago when there was no chance of treatment...
there is so much in life we do not have control over..but my exercise and my diet i do have control over...and my meds...
and who would have thought that i would now be into bird watching...lol...i spent three hours this morning enjoying the nature show outside my window...what a blessing!!!!
I too was dianosed at age 48. My heart function has improved a lot. I am sure yours will too. Being compliant about what the doctor tells you to do, your diet, taking meds, reducing stress, resting, etc. is the key.
By the way, I have taken up bird watching as well.....
nUMBER4940, Don't let the statistics freak you out. I did at first. Mortality rate for someone with Severe COPD and Cor Pulmonale, (my type of heart failure) is supposed to have been about two years. It has been two years for me, and I am still alive and kicking. Think positive, follow doctors orders and you'll do fine I'm sure. YOU are right, you are so young and that is in your favor. Best of luck to you. JOAnn
Cantbliev, you are going to die.... BUT not right now. You are going to take your meds, follow your doctors advice, eat right, and exercise. You are so young and there will be more medical advancements. You are going to live a long life(maybe not exactly the same as you had planned) but still long and happy and purposeful and fullfilling, etc. etc....Be happy!!!!
Shelly
JoAnn