Extreme stress can stun the heart muscle in what doctors call broken heart syndrome
Cardiomyopathy is not one illness but a family of diseases of the heart muscle itself. The muscle may thicken, balloon and weaken, or stiffen. One variety, Takotsubo, is triggered by severe emotional or physical shock. Early stages can be silent, yet the risk of sudden cardiac death rises.
Since 2013 the formal definition has centred on heart muscle that is abnormal in shape and function without another disease, such as blocked coronary arteries, high blood pressure or faulty valves, that would explain it. The main types are named for what the muscle does. In the hypertrophic form it grows thick. In the dilated form the ventricles stretch and lose strength. In the restrictive form they become rigid. Arrhythmogenic right ventricular disease and Takotsubo round out the list.
Causes range from genes to lifestyle. The hypertrophic type is usually inherited, and roughly a third of dilated cases are too. Dilated disease can also follow heavy alcohol use, cocaine, heavy metals, coronary disease or viral infection, while amyloidosis, iron overload and some cancer therapies can produce the restrictive type. Untreated coeliac disease is a striking example of a reversible trigger: diagnosed in time, the heart damage can fully resolve. Still, in many patients no cause is ever found.
Classification has shifted as genetics advanced. Tidy labels like thickened, dilated or restrictive proved hard to keep because one condition can meet several descriptions at different stages. The American Heart Association now splits cardiomyopathies into primary ones confined to the heart and secondary ones driven by illness elsewhere in the body, with genetic subgroups beneath.
Symptoms, when they come, reflect a failing pump: breathlessness on exertion, tiredness, and swelling of the legs, feet or abdomen. Treatment depends on type and severity and can include medication, pacemakers, implanted defibrillators, ventricular assist devices or, eventually, a heart transplant. In 2015 cardiomyopathy and myocarditis together affected 2.5 million people. A nationwide study spanning 2004 to 2023 found prevalence more than doubled over those two decades, with dilated disease the most common subtype and the youngest patients facing the steepest rise in excess mortality.
Source: Cardiomyopathy
