How Can I Prevent Cardiomyopathy from Happening?
Management of cardiomyopathy is tantamount to preventing aspects of it which can result in sudden cardiac death. All of the preventative measures for associated factors and unrelated comorbidities should be implemented to avoid mortality:
- Control of hypertension with antihypertensive medication
- Strict glycemic control and maintenance of target glycated hemoglobin A1c <7% for diabetics
- Weight management via diet/nutritional consultation, caloric restriction strategies, and lifestyle changes
- Smoking cessation and alcohol limitations
- Correction of dyslipidemia (elevated LDL-cholesterol, lower-than-normal HDL-cholesterol, elevated triglycerides) with statin drugs and follow-up for efficacy with serial blood work
- Diuretics for edema and to reduce volume overload which may contribute to pulmonary congestion/edema
- Cardioversion for atrial fibrillation
- Anticoagulation therapy for the prevention of thrombotic emboli that increase the risk of cardiac and peripheral (e.g., mesenteric) ischemia, infarction, and cerebrovascular accidents (stroke)
Direct involvement in recognizing the functional distortion of heart failure itself will impact morbidity and mortality, preventing disease progression that can negatively impact both:
- Early recognition and treatment of predisposing conditions (ischemic cardiac disease, hypertension, obesity and metabolic syndrome, unhealthy lifestyles, and sedentary habits)
- Early detection of left ventricular dysfunction (<40% ejection fraction) via echocardiography
- Treating both preserved ejection heart failure and reduced ejection heart failure will contribute to overall reduction in morbidity and mortality (antihypertensives, diuretics, vasodilators, sodium and fluid restriction, and anticoagulation prophylaxis)
- Treatment of left ventricular systolic dysfunction to prevent low output and decreased peripheral perfusion of end-organs (inotropic agents) and mechanical cardiac support (for those with severe disease–<25% ejection fraction: intraaortic balloon pump counter propulsion and extracorporeal membrane oxygenation devices)
Prevention of heart failure and heart failure-related complications runs the gamut from primary care to the use of specialists to implement aggressive strategies as the risks for morbidity and mortality rise.