|
Currently, there is no cure for dilated cardiomyopathy. However there are many available treatment methods that can both alleviate symptoms and treat underlying any underlying conditions that may be causing or aggravating the cardiomyopathy. In some cases, these treatments may reverse the process of dilated cardiomyopathy.
If symptoms are severe at the time of diagnosis, patients may need to be hospitalized for a period of time. When their condition has been stabilized, long-term treatment will be discussed. Treatment for dilated cardiomyopathy often focuses on reversing the underlying condition if possible. Some patients with cardiomyopathy can remain stable for long periods of time.
For patients with mild to moderate dilated cardiomyopathy, treatment plans may include health lifestyle changes, medications and/or surgery. Medications that may be prescribed fall into the following classes:
- Diuretics treat symptoms of heart failure by helping to flush fluids and minerals – primarily sodium – from the body.
- ACE inhibitors minimize the effort the heart must make to pump blood and help to prevent further dilation or enlargement of the ventricle. This helps to relieve symptoms and, more importantly, directly increases the chance for long-term survival by reducing the stress on the heart muscle.
- Angiotensin II receptor blockers work slightly differently than ACE inhibitors, but may also be used to increase the patient’s chance of survival by reducing the stress on the heart muscle.
- Beta blockers have also been shown to increase the patient’s chance of survival, as well as to limit the number of hospitalizations for heart failure and improve symptoms. They can improve the ejection fraction by protecting the heart from high levels of hormones in the blood. These hormones may initially help the failing heart, but can then contribute to its progressive dysfunction.
- Aldosterone inhibitors have recently been shown to prolong life when used along with standard medications. The landmark RALES study (Randomized Aldalactone Evaluation Study) found that, in patients with advanced heart failure already taking diuretics or ACE inhibitors, the addition of low-dose aldosterone inhibitor led to enhanced heart function and significant reduction in mortality.
- Digoxin strengthens the heart muscle and helps slow the heart rhythm. This is used to treat certain rapid arrhythmias such as atrial fibrillation are present.
- Vasodilators are sometimes recommended to lower a patient's blood pressure. This can make it easier for the heart to pump effectively by decreasing its workload.
- Anticoagulant medications prevent the blood from clotting, and can help prevent embolisms in patients with dilated cardiomyopathy.
- Ongoing studies are investigating whether some statins (a type of cholesterol reducing drug) exhibit a positive effect in dilated cardiomyopathy. Previous research with statins has already shown benefit on the coronary arteries of individuals with heart disease.
Physicians may recommend other treatment methods depending on the severity of the cardiomyopathy. For example, patients who survive sudden cardiac death or in who are at risk of death due to severe arrhythmias may benefit from a pacemaker or implantable cardioverter defibrillator (ICD). These devices are used to control the electrical impulses that make the heart beat.
Heart resynchronization therapy (biventricular pacing) is a type of pacemaker device that ensures activation of different portions of the heart at the same time, resulting in more efficient heart contractions. Many studies have shown that this procedure improves heart function and symptoms in certain suitable selected patients.
Heart transplantation may be necessary for patients in the advanced stages of heart disease who have a poor response to medical treatment and in whom the underlying problem could not be reversed or modified. Advanced dilated cardiomyopathy is the most common reason for heart transplantation, according to the National Institutes of Health.
Some patients with severe heart failure awaiting a heart transplant may be treated with a ventricular assist device. This is a mechanical pump that assists the failing heart that is implanted in open heart surgery.
In many cases, a physician will recommend lifestyle changes that may ease the symptoms of dilated cardiomyopathy. These may be recommended in conjunction with medication- or device-based treatment methods and generally include healthy lifestyle choices such as eating a heart-healthy diet, quitting smoking, getting regular exercise and limiting one’s alcohol use. Individuals should abstain from the use of any recreational drugs, such as cocaine.
Since dilated cardiomyopathy can be inherited, prospective parents should inform their physician of any family history of congenital heart disease. Genetic counseling, special prenatal/delivery care and other services may be recommended, depending on the nature of this problem and other heart problems.
|
/doctor_89.jpg "ulcerative colitis tips")
