Cardiomyopathy: Management & Treatment Menu

How Can Cardiomyopathy Be Managed?

Cardiomyopathy as heart failure requires treatment that attempts to restore function or compensate for dysfunction. The two distinct types of heart failure are:

  • Heart failure with preserved ejection fraction
  • Heart failure with reduced ejection fraction

Heart Failure with Preserved Ejection Fraction

These patients have symptoms and signs of heart failure but with a >50% left ventricular ejection (pump efficiency). Actual pharmacological or invasive management have not produced any promising therapies, so management is limited to addressing the associated signs and symptoms:

  • Hypertension management via diet: Exercise, weight management, and treating lipid elevations with statins; antihypertensive medication
  • Edema management via diuretics: To reduce volume overload that results in edema as well as ambulation, limb elevation, and compression stockings
  • Atrial fibrillation treatment: To restore sinus rhythm if possible if not beta blockers and calcium channel blockers to control the rate
  • Anticoagulation: To prevent thrombotic emboli and reduce the risk of stroke and cardiac or peripheral ischemia/infarction
  • Cardiac rehabilitation: that uses exercise training to improve exercise potential
  • Implantable pulmonary artery pressure monitor

Heart Failure with Reduced Ejection Fraction

Goals of management of heart failure with reduced ejection fraction are reduction of symptoms, increased function, lowering the rate of hospitalizations, and reducing the morbidity and mortality risks.

  • Manage contributing factors such as hypertension (beta blockers, ACE inhibitors, angiotensin II receptor blockers or inhibitors, and diuretics); renovascular disease (antihypertensive medication, revascularization); ischemic heart disease (angina relief, smoking cessation, lipid management, and for repeat episodes, myocardial revascularization); valvular disease (surgical correction); bradycardia (pacemaker); antithrombotic therapy; obstructive sleep apnea (PEEP mask)
  • Symptom control with beta blockers, ACE inhibitors, vasodilators (hydralazine), and aldosterone antagonists
  • Implantables, such as implantable cardioverter-defibrillator, cardiac resynchronization via biventricular pacemaker, or both
  • Cardiac rehabilitation that uses exercise training to improve exercise potential
  • A protocol of repeat evaluations and when indicated, repeat echocardiogram
  • Prolonged hospitalization for refractory cases
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This information is provided by Vascular Health Clinics and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.

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