Cardiology

Non-Ischemic Cardiomyopathy

NIC VideoNon-Ischemic cardiomyopathy is a generic term which includes all causes of decreased heart function other than those caused by heart attacks or blockages in the arteries of the heart.

The most common causes of non-ischemic cardiomyopathy are viral infection (viral myocarditis), drug reactions, inflammation or autoimmune reactions (lupus myocarditis, etc) or infiltrative processes (sarcoid, amyloid, etc).

Normal heart function, or ejection fraction (EF), is 55-65%. This means that with each beat, the heart pumps 55-65% of the blood inside the heart to the rest of the body. Cardiomyopathy implies some decrease in EF to less than 50% (which is considered borderline or low normal.)

Symptoms

  • Shortness of breath
  • Edema or swelling
  • Fatigue, especially with exertion
  • Unexplained weight gain
  • Shortness of breath when lying down

Diagnostic Tests


Treatment

  • Beta-blockers (atenolol, metoprolol, carvedilol, etc) can relax the heart, lower blood pressure and slow the heart to improve filling and pumping function.
  • Medications classified as ACE-inhibitors (lisinopril, enalapril, etc) or ARB’s (losartan, candesartan, etc) can also lower blood pressure, relax the heart and improved blood flow to the kidney.
  • Diuretics may be used to remove excess fluid.
  • Spironolactone can also be used to remove fluid and help relax the heart.
  • Pacemakers or defibrillators may be recommended in some cases.
  • Other treatments may be considered depending on the cause of the cardiomyopathy.

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