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Cardiomyopathy is a chronic disease wherein the muscles of the heart thicken or stiffen and get enlarged. Cardiomyopathy initially begins in the ventricles or lower chambers of the heart and progress to affect the upper chambers or atria. As the disease worsens, muscles and tissues of the heart get damaged and the heart loses its ability to pump blood efficiently. This category of cardiomyopathy is known as ischemic cardiomyopathy. There is also a non-ischemic type of cardiomyopathy that affects children.

Under this classification; the cause of the condition lies in the abnormal structure and function of the heart, and not in the progressive thickening of cell walls and muscles. Non-ischemic cardiomyopathy may be due to genetics or an infection or as a result of another underlying medical condition such as cancer or cystic fibrosis.

Types of Cardiomyopathy In Children

There are different types of cardiomyopathy that may affect children.

The four main types are:

• Dilated Cardiomyopathy In Children - This is the most common form of the disease. In this condition, to compensate for its weakened functioning, the heart enlarges in size and the heart muscles are stretched or dilated. Complications resulting from this type of cardiomyopathy include arrhythmias (irregular heart rates) and the formation of blood clots and emboli.
• Hypertrophic Cardiomyopathy In Children - In this type of cardiomyopathy, the left ventricle of the heart is enlarged and hypertrophied or thickened. This results in an irregular heartbeat and rapid pulse rate. Hypertrophic cardiomyopathy is largely hereditary.
• The other two types of cardiomyopathy - restrictive cardiomyopathy and arrythmogenic right ventricular cardiomyopathy are rarely found in children

Symptoms

Symptoms of cardiomyopathy will differ depending on the type of the condition and the child's age. There may be no symptoms in the early stages of cardiomyopathy in children. Symptoms may include:

• Feeling of breathlessness
• Constant fatigue or lethargy
• Irregular heartbeat or palpitations
• Heart murmur
• Pain in the chest
• Fainting spells
• Dizziness
• Poor weight gain
• Unresponsiveness in infants
• Vomiting or stomach pain

As the disease progresses, complications such as arrhythmias, blood clots, and congestive heart failure may develop. Symptoms of these complications include:

• Heartbeat that is too fast or too slow
• Chaotic, rapid heartbeat
• Water retention and build up of excessive fluid in the lungs and other parts of the body
• Difficulties in breathing
• Loss of appetite
• Intolerance of any form of exercise or physical activity
• Gastro-intestinal problems

Causes

There are a number of causes for a disease as complex as cardiomyopathy. However, the exact cause of the condition still remains unknown. Some possible causes of cardiomyopathy in children are:

• Genetic disorder
• Family history of cardiomyopathy
• Viral infections
• Auto-immune diseases during pregnancy
• Amyloidosis or excessive amounts of protein in the heart muscles
• Contact with certain toxins
• Certain medication such as cancer drugs

Treatment

After diagnosing the type and severity of the condition, the appropriate treatment will be prescribed. Treatment may include:

• Medications to help the heart pump better, reduce the size of the heart, and to regulate irregular heart rhythms
• If the disease has progressed and the child is at risk of a life-threatening arrhythmia or possible heart failure, devices such as a pacemaker or an implantable defibrillator may be required.
• Surgery or heart transplant may be necessary in severe cases.

Follow-up care is essential for children with cardiomyopathy. Children will have to visit a pediatric cardiologist regularly. Genetic screening and testing may be encouraged if genetics is the suspected cause of cardiomyopathy in the child. This will help ensure that other members of the family do not have the disease as well.

References

• http://www.chop.edu/service/cardiac-center/heart-conditions/cardiomyopathy.html

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