The heart is made up of muscle, valves, supporting structures, an electrical conduction system and blood vessels.
This condition makes the heart unable to pump blood effectively. The thin, flabby heart muscle is weak and cannot function properly. This results in a variety of symptoms.
This is often a disorder that develops slowly over time. An affected person may notice: shortness of breath, especially when laying flat or exercisingchest painfatiguelung congestion, known as pulmonary edemaswelling in the legs, known as edema
A physical exam may reveal: low blood pressureliver enlargementabnormal collections of fluid inside the abdomen, called ascitesabnormal heart sounds, called heart murmursan abnormally fast heart ratesounds of fluid in the lungsenlarged neck veinsswelling of the legs from fluid buildup
Sometimes the condition is inherited, but in many cases the cause is unknown. Other possible causes include: infections of the heart muscle, such as myocarditis from a viral infectionalcohol dependence or cocaine abusecertain chemotherapy medications used to treat cancer, such as doxorubicin(i.e., Adriamycin) and cyclophosphamide (i.e., Cytoxan)exposure to certain chemicals or toxins, such as mercury, lead, and cobaltdiseases affecting the thyroid gland, such as hypothyroidism, or low thyroid hormone levels in the bodyan abnormally high secretion of growth hormone in children with acromegalylow levels of phosphate and calcium in the bodyAIDS, due to HIV infectiondeficiency of thiamine, also known as vitamin B1autoimmune disorders, such as rheumatoid arthritis, which occur when a person's immune system attacks his or her own body
In many cases, this disease cannot be prevented. Avoiding alcohol, cocaine, and other toxic agents can prevent some cases.
A healthcare provider may suspect this disease from the health history and physical exam. A heart tracing (ECG) and chest x-ray may show characteristic changes.
Echocardiography, a test that uses sound waves to look at the heart, can show the flabby heart muscle and how poorly it pumps blood. Other special x-ray tests may also be used in some cases.
Rarely, a biopsy of the heart muscle is advised. This is a procedure to remove a small piece of heart muscle so that it can be analyzed in a lab.
This is a very serious condition with a relatively high risk of death. Unless there is a treatable cause, little can be done to prolong life. Death usually occurs from heart failure, irregular heartbeats, or blood clots that develop in the heart.
There are no risks to others.
Those with exposure to toxic substances, such as cocaine or alcohol, need to stop the exposure right away. Those with treatable causes, such as hypothyroidism, need treatment for the cause. In these cases, treatment may help the heart get back much of its normal function.
In cases without a treatable cause, heart medications are used to help the heart pump more effectively. Other heart medications help prevent irregular heartbeats, called arrhythmias. Diuretics (water pills), and reducing salt in the diet can help prevent fluid buildup in the body.
Affected people need plenty of rest and stress reduction. Exercise is encouraged if the person is able. Severely affected people may need a heart transplant.
Every type of medication has its own set of side effects. For instance, diuretics can cause dehydration and salt imbalances. A heart transplant is a high risk surgery that may result in bleeding, infection, or death.
The condition often becomes more severe with time even with the best treatment, and is often fatal. Newer heart medications may slow the progression of the condition. After a heart transplant, people need close monitoring and must take powerful medications to prevent rejection of the new heart. If successful, a transplant will prolong life.
The medications used to help strengthen the heart need to be monitored and often adjusted. After a heart transplant, a person is watched closely to see if his or her body will reject the new heart.
Merck Manual 1999
Current Medical Diagnosis and Treatment 1996
Harrison's Principles of Internal Medicine 1991