Cardiomyopathy in adults: what is it?
Group processes noninflammatory nature in the heart muscle associated with metabolic disorders in cells, it is called «cardiomyopathy». This is a common disease, it often affects adults, regardless of sex under the influence of a significant number of reasons.
Pathogenesis (mechanism of development) cardiomyopathy, what is it?
The main function of the heart is to eject blood from the cavities into the vessels (pump function). This is achieved through the rhythmic contraction of miocardiotita (cardiac muscle cells). Permanent reduction of cardiomyocytes provides a significant basal metabolic rate (metabolism) and energy in them. Under the influence of various factors there is a violation of metabolism in the cells of the myocardium, which over time leads to the development of structural changes in them, disruption of contractility, which is the basis of the mechanism of development of cardiomyopathy.
Causes and types
Cardiomyopathy is a pathological condition with multiple causative factors. This means that it brings the impact of a significant number of various factors that cause the violation of metabolism in cardiomyocytes. Depending on the leading etiological factor that led to the development of the disease, distinguish several main types of cardiomyopathy:
- Dysplastic – has an innate nature, pathology develops due to improper laying of the structures of the heart during fetal development. This type of cardiomyopathy is characterized by enlargement of the heart valves and the development of valvular heart diseases with subsequent expansion of the cavity is dilated form. She is the reason for the formation of blood clots, and sudden cardiac death in young adults.
- Dishormonal more often develops in women in menopause, which is associated with a decrease in levels of sex hormones in the body (estrogen, progesterone). This affects the metabolism of cardiomyocytes, and significantly increases the risk of heart failure.
- Dysmetabolic – this type of cardiomyopathy is caused by changes in the General metabolism of the body, it often develops on the background of diabetes mellitus and altered functional activity of the thyroid gland, which produces hormones that are responsible for the intensity of metabolic processes in the body. The metabolic component of the development of myocardial pathology in its origin has no inflammatory changes.
- Post hypoxic – develops as a result of impaired blood flow in the myocardium against coronary disease. Insufficient intake of oxygen in cardiomiocity for quite a long time causes irreversible changes in metabolism with the development of cardiomyopathy.
- Ischemic is a form of cardiomyopathy, which has a close relationship with posthypoxic form, it occurs when coronary heart disease caused by narrowing of the coronary arteries that feed the myocardium.
- Tonzilliarnaya – violation of the metabolism of cardiac muscle cells develops as a result of autoimmune inflammation. After suffering tonsillitis (infection of inflammation of the tonsils) caused by the bacteria Streptococcus mutans, formed the violation of the functional activity of the immune system, which produces autoantibodies that damage the cardiomyocytes and cause metabolic disorders in them.
- The toxic form is one of the most frequent forms of cardiomyopathy, intake of toxic substances leads to significant metabolic changes in cardiomyocytes. A variant of this form is to alcoholic cardiomyopathie, which develops on the background of systematic use of alcohol.
- Functional – metabolic disorders in the tissues of the heart causes a disturbance of the innervation of the myocardium. Usually this type of cardiomyopathy develops in teenagers in connection with a change in the functional activity of the vegetative nervous system, exerting a regulatory effect on all organs and systems of the body.
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Also is allocated a primary and secondary form of cardiomyopathy. In primary cardiomyopathy pathological metabolic disorders in cardiomyocytes has been developing in newborns and has an innate origin. To establish a credible cause of disease is not identified (idiopathic cardiomyopathy). In secondary cardiomyopathy changes in the heart usually develop in adults after the impact of the etiological factors of the disease.
The basis of the clinical signs of cardiomyopathy is the appearance and increasing intensity of symptoms of heart failure, which include:
- Shortness of breath characterized by feeling short of breath, at the initial stage of heart failure it develops during exercise, then it may occur alone.
- Fatigue – extreme weakness appears even when performing small physical work.
- Swelling in the legs occurs due to effusion of plasma into the extracellular matrix of blood vessels, which is associated with slow blood flow due to heart failure. They appear mainly in the evening, then progression of the pathological process in the heart can be permanent. Severe heart failure is manifested by effusion of fluid in the peritoneal cavity (ascites) and lungs with the development of cough.
- Acrocyanosis – blueness of the skin fingertips, nose, lips, which is the result of venous congestion.
Also a violation of metabolism in cardiomyocytes may lead to the occurrence of pain in the heart area, which may have different nature (pinching, tingling) depending on the reasons for the development of the pathological state. The exact characteristics of the disease, the cause and extent of changes in the tissues of the heart are determined with additional research which includes ECG, echocardioscopy and other research methods.
The treatment of this disease holds the doctor-the cardiologist. It aims to eliminate exposure to the etiological factor, as well as restoring the metabolism of cardiomyocytes with the help of drugs – of cardioprotectors.