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Cardiomyopathy in Children

Cardiomyopathy is a group of disorders that affect the heart muscle. It can make the heart muscle become thicker or grow larger. It is a common cause of heart problems in children. Roughly 1 child out of 100,000 is diagnosed with cardiomyopathy. Most children are diagnosed before the age of 2.1

Dilated cardiomyopathy

Dilated cardiomyopathy (DCM) is the most common type of cardiomyopathy in children. It is most often diagnosed in children below the age of 1. It makes up around half of cardiomyopathy cases in children. DCM causes some parts of the heart to become dilated (stretched out).1,2

Possible causes of DCM include:1-3

  • Infections
  • Myocarditis (inflammation of the heart caused by infections)
  • Chemotherapy
  • Nerve and muscle (neuromuscular) disorders
  • Metabolic disorders
  • Genetics (inheriting certain genes from the parents)

DCM makes it difficult for the heart to pump blood. This is also called congestive cardiac failure. It can make it harder for other organs to work properly. If DCM is not treated, it can lead to a variety of symptoms that may get worse over time. Some of the symptoms are:1-3

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  • Fast heart rate
  • Fast breathing
  • Shortness of breath
  • Tiredness
  • Irritability
  • Chest pain
  • Loss of appetite
  • Pale skin
  • Not being able to eat
  • Slow growth
  • Vomiting
  • Clammy skin
  • Abdominal pain
  • Swollen belly, legs, or feet

Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM) causes the heart muscles to become thick. It usually affects the left ventricle (lower part of the heart). Thickening of the left ventricle makes it harder for the heart to pump blood to the rest of the body.1-3

HCM is mostly genetic. Parents pass down certain genes to their children that can cause HCM. More than half of children with HCM also have close family members with enlarged or thickened heart muscle.1,2

Some of the symptoms of HCM are:1-3

  • Chest pain
  • Fainting
  • Dizziness
  • Irregular heartbeat
  • Shortness of breath during exercise
  • Difficulty exercising

Rare types of cardiomyopathies

Restrictive cardiomyopathy (RCM) makes the heart muscles stiff. As a result, the heart muscles are not able to fill completely when pumping blood. Unlike other types of cardiomyopathies, RCM is not as common in young children.2,3

Arrhythmic right ventricular cardiomyopathy (ARVC) causes the right ventricle of the heart to develop scar tissue. As a result, the heart is not able to maintain a regular heartbeat. ARVC causes arrhythmia (irregular heartbeat).2,3

How is cardiomyopathy diagnosed?

Cardiomyopathy can be diagnosed using different tests, such as:4

  • Blood tests – A blood test may be used to see if all the organs are working properly. The presence of certain proteins can be a sign of heart failure.
  • Electrocardiogram (EKG or ECG) – This test looks at the electrical activity of the heart. It can show if the heart is not beating regularly.
  • Imaging tests – Different types of tests can be used to see what the heart looks like. Having cardiomyopathy can make the heart larger, which can be seen using imaging tests. Some examples of imaging tests are X-ray, echocardiogram, and MRI.
  • Genetic testing – Genetic testing can be done to look for certain genes that are linked to cardiomyopathy. Your doctor might recommend genetic testing if there is family history of cardiomyopathy.

Treatments for cardiomyopathy

Treatments are available that can help manage symptoms and reduce the risk of heart failure in children and adults. The exact treatment will depend on the type of cardiomyopathy and the symptoms. Possible treatments include:4,5

  • Medicine – Drugs are used to protect the heart and help it work better. They can be used to lower heart rate and blood pressure. Some examples are beta-blockers and ACE inhibitors.
  • Surgery – There are different types of devices that can be placed near the heart using surgery. These devices can either help the heart pump blood or beat regularly.
  • Heart transplant – If drugs and surgical procedures do not help, your doctor might recommend a heart transplant.

Over the past few decades, the survival rate after being diagnosed with cardiomyopathy has improved significantly. As newer drugs and treatments are being tested, the survival rate will likely continue to increase.5

Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.

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