"Heart Disease and Stroke Recovery Services"

Heart Disease - Disease of the Heart Muscle

These are of two:
  1. Myocarditis  - This describes inflammation of the heart muscle due to infection and Toxins.
  2. Cardiomyopathies This refers to chronic disorders of heart muscle of varying causes.

Myocarditis - Heart Muscle Disease:

This is often the result of infections usually viral. In Barbados a bacterial infection, leptospirosis, is a common cause. Other environmental agents may transfer the condition e.g. some drugs heavy metal poisoning, radiation, mild cases may cause only cardiac arrhythmias, sever cases may also produce heart failure with its usual symptoms of dyspnoea and fatigue may even produce acute circulatory failure (shock) and sudden death. Occasionally there may be an associated chest pain. There is no specific treatment, but the sufferer needs rest and management of any complication.

Cardiomyopathies Heart Muscle Disease:

There are three distinct clinical types.
  1. Dilated Cardiomyopathy:  This the commonest form. The cause is usually unknown, although it is likely that the majority may develop following a viral illness.

    Some cases may be entirely due to chronic alcohol abuse, and alcohol generally tends to worsen the condition. The usual symptoms of heart failure develops: -dyspnoea, fatigue, oedema, abdominal swelling.

    Treatment in the short term involves bed rest, alcohol avoidance, antiarrythmia and antifailure medications.

    However the outlook is poor and very few survive beyond 5 years after diagnosis. At present, heart transplantation hols the only long-term hope.
  2. Hypertrophic obstructive Cardiomyopathy (HOCM): Here there is massive hypertrophy (overgrowth) of the left ventricles and this may be severe enough to obstruct the outflow of blood into the aorta.

    This is often a familial condition with a history of heart disease or sudden death in relatives. The symptoms mimic those of aortic stenosis including effort synocope, angina and dyspnoea. Arrhythmias are common and sudden death may occur. Considerable relief of symptoms may be obtained through such medications as Beta Blockers and Calcium Channel Blockers. Surgical resection of part of this thickened muscle is a helpful option.  
  3. Restrictive Cardiomyopathy: This describes a rigid myocardium and is very rare, fortunately, since treatment is seldom effective except in those cases where there is endomyocardial fibrosis. These cases may benefit from surgical resection and those with an associated eosinophila may benefit from corticosteroid and cytotoxic drug therapy. The clinical features are the usual ones of heart failure: - abdominal swelling, ascites, oedema and dyspnoea.