Cardiomyopathy is a disease of the heart muscle that makes it harder for the heart to pump blood to the rest of the body. Cardiomyopathy can lead to heart failure.

The main types of cardiomyopathy include

Dilated Cardiomyopathy: The main pumping chamber of the heart – left ventricle — becomes enlarged (dilated) and can’t effectively pump blood out of the heart. Although this type can affect people of all ages, it occurs most often in middle-aged people and is more likely to affect men. The most common cause is coronary artery disease or heart attack.

Hypertrophic Cardiomyopathy: This type involves abnormal thickening of the heart muscle, particularly affecting the muscle of the heart’s main pumping chamber (left ventricle). The thickened heart muscle can make it harder for the heart to work properly.

Hypertrophic cardiomyopathy can develop at any age, but the condition tends to be more severe if it becomes apparent during childhood. Most affected people have a family history of the disease, and some genetic mutations have been linked to hypertrophic cardiomyopathy.

Restrictive cardiomyopathy: The heart muscle becomes rigid and less elastic, so it can’t expand and fill with blood between heartbeats. This least common type of cardiomyopathy can occur at any age, but it most often affects older people. Restrictive cardiomyopathy can occur for no known reason (idiopathic), or it can be caused by a disease elsewhere in the body that affects the heart, such as when iron builds up in the heart muscle (hemochromatosis).

Arrhythmogenic right ventricular dysplasia: In this rare type of cardiomyopathy, the muscle in the lower right heart chamber (right ventricle) is replaced by scar tissue, which can lead to heart rhythm problems. It’s often caused by genetic mutations.

Treatment might include medications, surgically implanted devices or other interventional / surgical procedures, in severe cases, heart transplant may be needed.

Treating Heart Failure with Implanted Devices

Implantable cardiac defibrillators (ICD): are small, battery-powered devices that generate electrical impulses and perform pacing / give direct current shock to revive a patient from cardiac arrest due to ventricular tachycardia/fibrillation.

Cardiac Resynchronization Therapy (CRT): This treatment uses a special pacemaker by a heart transplant surgeon that syncs the left and right ventricles of heart failure patients, to make it pump more efficiently. This can be combined with an implantable cardiac defibrillator.

Mechanical-Assist Devices

• An intra-aortic balloon pump (IABP) increases cardiac output and blood flow, which is usually placed inside the main blood pipe (aorta) through a blood vessel in the groin.
• Temporary assist devices are mechanical pumps that help the heart pump blood through the body. They allow the heart to stabilize while the care team decide what other treatment options are best.
• Ventricular assist devices (VADs) are permanent mechanical pumps that help the heart pump blood through the body. This can be left ventricular assist device (LVAD) or right ventricular assist device (RVAD)

LVADs are a therapy for end-stage heart failure and an alternative to heart transplant for some patients.

Heart Transplant

Advanced heart failure due to dilated and ischemic cardiomyopathies, complex congenital heart disease and life threatening arrhythmias despite optimal treatment. Prior to consideration of heart transplant in Chennai, India, a comprehensive evaluation of patient is carried out including a thorough multiorgan and multidisciplinary workup. Some of the contra indications to a transplant include irreversible pulmonary hypertension, recent history of malignancies, active infection and multiple organ dysfunction. Suitable candidates are placed on the waitlist for transplantation. After surgery, they would be commenced on lifelong immunosuppression and managed by a multidisciplinary team with attention to rehabilitation and typical discharge from the heart transplant hospital within two to three weeks. Post-transplant, they would be reviewed at regular intervals for surveillance of graft function and patient’s well-being with emphasis on identifying episodes of acute rejection and infection. Currently the one-year survival post heart transplantation is 85-90%. About 30-40% may develop chronic rejection in the form of cardiac allograft vasculopathy by 5 years and 60% are expected to survive beyond 10 years post-transplant. Majority of heart transplant recipients return to a normal quality of life and 30% return to active employment. To book an appointment with our experts or to learn more about heart transplant costs, contact us at +91 9150277712.