Cardiomyopathy: What Parents and Children Need to Know

How Does Cardiomyopathy Affect the Heart?

• Weakened Heart Muscle: In some children, the heart's walls stretch and become too thin. This makes it harder for the heart to pump blood (called Dilated Cardiomyopathy).
• Thickened Heart Muscle: In other cases, the heart muscle becomes too thick, especially in the area that separates the heart’s chambers. This can block blood flow and make the heart work too hard (Hypertrophic Cardiomyopathy).
• Stiff Heart Muscle: Sometimes, the heart muscle becomes stiff and can’t relax properly, so it doesn’t fill with blood as it should (Restrictive Cardiomyopathy).
• Heart Rhythm Issues: When scar tissue develops in the heart muscle, it can cause irregular heartbeats (Arrhythmogenic Cardiomyopathy). This can lead to dizziness, fainting, or a fast heartbeat.

What Causes Cardiomyopathy?

Some children are born with a risk of developing cardiomyopathy, while others develop it over time. Possible causes include:

• Genetics: A child may be more likely to develop cardiomyopathy if other family members have cardiomyopathy.
• Infections: Viral infections can attack the heart muscle and cause it to swell.
• Heart Disease: Children born with heart defects may develop cardiomyopathy later.
• Nutritional Deficiencies: Lack of certain vitamins and minerals can weaken the heart muscle.
• Autoimmune Conditions: Illnesses like lupus or rheumatoid arthritis can affect the heart muscle.
• Lifestyle Factors: Things like alcohol or drug use (more relevant for teenagers and adults) can harm the heart.

What Are the Symptoms of Cardiomyopathy?

Symptoms of cardiomyopathy in children can develop slowly or appear suddenly. Parents need to watch for these signs:

• Tiredness and Fatigue: Your child may feel more tired than usual, even with simple activities.
• Breathing Problems: Shortness of breath, especially during play or at rest, could be a sign of heart issues.
• Swelling: Look for swelling in the feet, legs, or around the eyes, which could mean fluid is building up.
• Chest Pain: Some children may complain of chest pain, especially after physical activity.
• Fast or Irregular Heartbeat: A racing or “fluttering” heart may indicate an abnormal heartbeat (arrhythmia).
• Dizziness or Fainting: If your child feels dizzy or faints, especially during exercise, it’s important to see a doctor right away.

How is Cardiomyopathy Diagnosed?

To find out if your child has cardiomyopathy, a paediatric cardiologist may recommend:

• Physical Exam: The doctor will check for swelling, listen to the heart with a stethoscope, and ask about symptoms.
• Imaging Tests:
• Echocardiogram (Echo): This ultrasound scan shows how well the heart is pumping and can detect enlarged, thickened, or stiff heart muscles.
• MRI: A detailed scan of the heart that can show scarring or damage in the heart muscle.
• X-Ray: Helps identify if the heart is enlarged or if fluid is building up in the lungs.
• Electrocardiogram (ECG/EKG): This test tracks the heart’s electrical signals to see if there are any abnormal rhythms.
• Stress Test: Older children and teens may be asked to walk on a treadmill while their heart is monitored.
• Blood Tests: These can check for signs of heart damage, infection, or other health issues.
• Genetic Testing: If other family members have cardiomyopathy, genetic testing may be recommended to see if your child is at risk.

How is Cardiomyopathy Treated?

Treatment depends on the type of cardiomyopathy and how it’s affecting the child. Possible treatments include:

Lifestyle Changes

• Healthy Eating: A heart-friendly diet with fruits, vegetables, whole grains, and lean proteins supports heart health.
• Regular Check-Ups: Regular visits to the cardiologist help monitor heart health and detect problems early.
• Physical Activity: Some children may need to limit high-intensity sports, but staying active in other ways can help keep the heart healthy.

Medications

• Diuretics: These “water pills” reduce fluid buildup in the body.
• Beta-Blockers: These help slow the heart rate and improve its pumping ability.
• ACE Inhibitors/ARBs: These relax blood vessels and make it easier for the heart to pump blood.
• Antiarrhythmics: These medications help regulate abnormal heart rhythms.
• Anticoagulants (Blood Thinners): These are used if there’s a risk of blood clots forming.

Devices and Surgery

• Pacemakers: Small devices implanted under the skin to help control the heart's rhythm.
• Implantable Cardioverter Defibrillator (ICD): This device monitors heart rhythms and delivers a shock if a dangerous rhythm occurs.
• Left Ventricular Assist Device (LVAD): A mechanical pump that supports heart function in severe cases.
• Heart Transplant: In very rare cases, when other treatments don’t work, a heart transplant may be necessary.

How Can Parents and Children Cope with Cardiomyopathy?

Living with cardiomyopathy can be challenging for children and families, but support is available. Here are some ways to manage it:

• Education and Understanding: Talk to your child about their heart and explain the condition in a way they can understand.
• Emotional Support: It’s natural for children to feel worried or upset. Encourage them to talk about their feelings and offer reassurance.
• School and Play Adjustments: Inform teachers, coaches, and caregivers so they can make appropriate adjustments for your child.
• Support Groups: Join support groups for families living with cardiomyopathy. It helps to connect with other parents going through the same experience.

Can Cardiomyopathy Be Prevented?

Not all cases of cardiomyopathy can be prevented, especially if it’s inherited. However, parents can help their child stay heart-healthy by:

• Regular Check-Ups: Early detection and monitoring can catch potential issues before they become serious.
• Healthy Lifestyle: A balanced diet, regular activity, and avoiding smoking or drug use can support heart health.
• Family Screening: If cardiomyopathy runs in the family, testing can detect risks early, leading to better treatment options.

When Should You See a Doctor?

Call a doctor if your child experiences:

• Sudden shortness of breath or breathing problems
• Unexplained fainting or dizziness, especially during activity
• Fast, irregular heartbeats that don’t go away
• Swelling in the feet, legs, or abdomen
• Sudden chest pain that doesn’t go away

Remember:

Cardiomyopathy can be managed with early diagnosis, treatment, and lifestyle changes. Children with cardiomyopathy can still have happy, active lives with the right care and support. If you have questions or concerns, Dr. Youssef is here to provide expert guidance and compassionate care.