Pediatric Cardiomyopathy

For many individuals, symptoms may not present themselves at all throughout their life or only present themselves once the condition progresses.

Common symptoms associated with cardiomyopathy are:

• Breathlessness, both active and inactive 
• Swelling of the legs, ankles and feet
• Abdominal bloating from fluid buildup
• Coughing while lying down
• Fatigue/exhaustion
• Rapid, pounding, or fluttering heartbeats
• Discomfort or pressure in the chest 
• Dizziness

Cardiomyopathy differs from many of the other disorders of the heart in several ways, including the following:

• Cardiomyopathy can, and often does, occur in children.
• The condition is fairly uncommon, affecting only about 50,000 Americans (adults and children).
• Cardiomyopathy is a leading cause for heart transplantation.
• The condition tends to be progressive and sometimes worsens fairly quickly.
• It may be associated with diseases involving other organs, as well as the heart.

Viral infections that infect the heart are a major cause of cardiomyopathy. In some instances, cardiomyopathy is a result of another disease or its treatment, such as:

• Complex congenital (present at birth) heart disease
• Nutritional deficiencies
• Uncontrollable, fast heart rhythms 
• Certain types of chemotherapy for childhood cancers. 
• A family history of cardiomyopathy or genetic abnormality

Other times, the cause is unknown.

Three types of cardiomyopathies are:

• Arrhythmogenic right ventricular cardiomyopathy (ARVC)
• Hypertrophic cardiomyopathy (HCM)
• Dilated cardiomyopathy (DCM)
• Restrictive cardiomyopathy (DCM)

ARVC is a rare type of cardiomyopathy that occurs if the muscle tissue in the right ventricle dies and is replaced by fat or scar tissue:

• This process disrupts the heart's electrical system, causing arrhythmias.  
• It usually affects teens and young adults.  
• Symptoms include heart palpitations and fainting after physical activity. In later stages, it can affect the left ventricle and cause heart failure.
• It can cause sudden cardiac arrest in young athletes.                
• It may require implantation of a device to prevent death from an arrhythmia.

Hypertrophic cardiomyopathy occurs when the muscle of the left ventricle thickens. This can block blood flow to the rest of the body. Hypertrophic cardiomyopathy can affect the heart's mitral valve, causing blood to leak backward through the valve.

• This is a rare disease and in most cases is inherited.
• It can affect people of all ages. Symptoms can appear in childhood or adulthood.
• Symptoms include shortness of breath on exertion, dizziness, fainting, and chest pain (angina).
• Some people have arrhythmias, which may lead to sudden death.

Dilated cardiomyopathy is the most frequent form of cardiomyopathy. The cavity of the heart is enlarged and stretched, compromising the heart's ability to pump normally and relax appropriately:

• This occurs most often in adults ages 20 to 60. It's more common in men than women. But it has been diagnosed in people of all ages, including children.
• Most people eventually develop heart failure.
• Dilated cardiomyopathy can be caused by chronic, heavy alcohol use and nutritional deficiencies tied to alcoholism.
• It sometimes occurs as a complication of pregnancy and childbirth.
• Other possible causes include alcohol abuse, infections, and illegal drugs. It can also be inherited due to a genetic disorder. Sometimes medicines used to treat a different medical condition can
• damage the heart and cause dilated cardiomyopathy. However, in most cases, a specific cause is never found.
  
   

Restrictive cardiomyopathy occurs when the heart muscle becomes stiff and not able to fill with blood properly. It's the least common type of cardiomyopathy in the United States.

• It often occurs due to an underlying problem such as amyloidosis, hemochromatosis, scleroderma or sarcoidosis.
• Restrictive cardiomyopathy does not appear to be inherited, but some of the diseases that lead to the condition are inherited.
• Symptoms may include fatigue, swelling of the arms and legs, and trouble breathing on exertion.
  
   

Specific treatment for hypertrophic cardiomyopathy will be determined by your child's physician based on:

• Your child's age, overall health and medical history
• Extent of the disease
• Your child's tolerance for specific medications, procedures or therapies
• Expectations for the course of the disease
• Your opinion or preference

Your child's physician may recommend medications to accomplish the following:

• Decrease the workload of the heart
• Decrease the oxygen requirements of the heart
• Regulate irregular heartbeats

Surgical treatment may include:

• Removal of part of the enlarged muscle
• Artificial pacemaker
• Heart transplantation