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Cardiomyopathy

When the structure or the functioning of the muscles in the heart develops some sort of abnormality, then it results in a condition known as cardiomyopathy in the patient. Cardiomyopathy as a condition is of three main or major types, the first one is known as dilated congestive cardiomyopathy, the second one is known as hypertrophic cardiomyopathy, and the third one is known as restrictive cardiomyopathy.

Dilated congestive cardiomyopathy (DCM) is the most common type seen in affected individuals. This condition is caused by the damage sustained in the muscles of the heart, thus during DCM commonly occurs as a corollary of coronary artery disease-more commonly known as atherosclerosis, in the patient. The risk of being afflicted with DCM also increases in diabetic individuals and it seems that compared with normal individuals, diabetics are at a much greater risk from this form of the condition. Some other factors and related conditions that can trigger incidences of cardiomyopathy of the DCM type include the presence of connective tissue diseases in the individual, pregnancy is a risk factor in women, and certain hereditary factors can also bring about the condition. Other factors that can trigger or lead to the condition include alcohol abuse, certain infections in the body, the exposure to certain drugs and toxins, and many forms of nutritional deficiencies, all of these factors put a person at a higher risk of developing the DCM form of cardiomyopathy.

The effectiveness of the pumping action of the heart gradually lessens and disappears during DCM, in an individual. Self treatment is not suggested while dealing with this condition as all incidences of cardiomyopathy are considered serious health conditions requiring prompt medical attention, diagnosis and treatment. The aim of other alternative approaches aim at reducing the chances or preventing the development of DCM by controlling and removing all known risk factors in the individuals. Thus if diseases and other conditions like atherosclerosis, hypertension and diabetes and many other types of heart diseases like congestive heart failure are removed or reduced in the person, then these lifestyle changes could possibly reduce or remove the chances of DCM developing in the individual.

The second form of cardiomyopathy is known as hypertrophic cardiomyopathy and while this form of the condition seems to have a higher rate of incidence in people with hypertension, it is known that this form of the condition is a hereditary disorder, and involves genetic factors in its incidence and development in an individual. The presence of an autoimmune disorder, conditions like cancer, and other forms of connective tissue disease can all lead to the restrictive form of cardiomyopathy. Compared to the first form of the condition, the incidence of the hypertrophic and restrictive forms of cardiomyopathy is relatively rare in the majority of patients.

Individuals afflicted with all forms of cardiomyopathy suffer from exhaustion and physical fatigue and tire readily in most instances, a large majority of such patients also have difficulty breathing when undertaking even very light exertion. The enlargement of the abdomen and swelling around the ankles are some of the other chronic symptoms associated with all three forms of cardiomyopathy.

While incidences of a risk factor for cardiomyopathy known as PCM-protein-calorie malnutrition (PCM) rarely occurs in the U.S., this factor can lead to incidences of cardiomyopathy and is a common cause for the condition in other parts of the world.

Excessive drinking is a very common cause of cardiomyopathy in many people and this risk factor is a frequent cause of all forms of the condition. Compared to all the other demographic groups, all alcoholics stand at a significantly greater risk of developing a deficiency of the vitamin thiamine-vitamin B1.This deficiency of the vitamin can also lead to other conditions and thiamine deficiency disease like wet beri beri or Shoshin beri beri, these conditions become risk factors in the person and frequently cardiomyopathy results or accompanies these conditions.

Even among the all alcoholics, women as a demography stand at a much higher risk of developing DCM is compared to the men. For this reason and others the consumption of alcohol is not recommended for people affected by cardiomyopathy, and all doctors strongly recommend individuals with cardiomyopathy to abstain from all alcoholic products. This is a good idea as even in individuals in whom cardiomyopathy has already set in because of alcoholism, the condition can simply disappear if the consumptions of alcohol are stopped and full recovery is possible.

There are other problems associated with cardiomyopathy, that is patients can develop life threatening complications if they undertake even moderate to heavy physical activity, this need not always be the case as sufficient and regular exercise is good for general health and can help alleviate the condition in most people; exercise must not be strenuous. The amount of exercise and physical exertion that can be undertaken will depend a great deal from one patient to another among all patients afflicted with cardiomyopathy. Therefore it is very important that all physical exercise programs undertaken by cardiomyopathy patients take place with professional supervision or under the watchful eye of a doctor.

The number of cigarettes smoked on a daily basis will tend to increase the risk of developing cardiomyopathy, therefore, as demography all smokers are at a risk of developing this condition and heavy smokers are the group most likely to develop the condition. Strangely smokers with DCM have a much lower mortality rate when compared with smokers who have not developed cardiomyopathy, why this paradoxical situation occurs in this demographic group is still not certain and will take time to be positively concluded. Smoking is not good in general and all doctors are agreed that especially in those smokers who have DCM, the risks of other health related conditions increases and therefore such patients must give up smoking as soon as possible.

Supplements and herbs

An important biological compound called coenzyme Q10 is known to be deficient in the bodies of people afflicted with the form of cardiomyopathy known as DCM. This has been further borne out by the observed fact that such patients show an increased survival rate, heart function rates and improvement in their quality of life in all studies that were done using supplements of the coenzyme Q10 during the treatment of cardiomyopathy. Even in the less common form of the cardiomyopathy known as hypertrophic cardiomyopathy the use of coenzyme Q10 as a supplemental compound elicited an improvement in the cardiac function in the patients under study. However, it must be mentioned here that in some people with cardiomyopathy, supplementation with the CoQ10 in a few studies showed absolutely no results and did not lead to the improvement in condition of the patients. Doctors commonly recommend dosage levels of 100 to 150 mg every day along with meals for supplementation purposes in the treatment of cardiomyopathy even though there is a lack of consistency in the outcomes of published research.

The development of cardiomyopathy in some patients is linked to the deficiency of L-carnitine-an amino acid, in the body of the individual. In fact, this particular supplement is the most effective in treating cardiomyopathy of the inherited type normally observed in children; this form of hereditary cardiomyopathy is the most responsive to therapy with L-carnitine as a supplement. It remains to be verified as to whether the supplements of carnitine help the average person with cardiomyopathy where this has been carried out. However, most doctors will suggest 1 to 3 grams of carnitine every day for adults of medium weight suffering from cardiomyopathy.

Animal studies show that supplementation with taurine, another amino acid, brought benefits in animals afflicted with cardiomyopathy and these veterinary studies were quite conclusive in the results. Therefore at least where animals are concerned, a definite link between cardiomyopathy and taurine deficiency has been shown. Symptoms improve and survival rates from the condition increased in all the animals afflicted with cardiomyopathy in whom supplementation was carried out using taurine; these animals had the form of cardiomyopathy known as DCM. While these results are good where animals are concerned, no definite studies have shown conclusive results in the treatment of cardiomyopathy using taurine and so because the clinical studies in humans are lacking, its potential benefits for treating human forms of cardiomyopathy remains largely unknown; this is in spite of the excellent safety record that such supplementation showed in the veterinary studies. Therefore things being the way they are, taurine supplementation during cardiomyopathy will have to be obtained from dosage decisions that doctors normally suggest when using taurine to treat people with other conditions; this amino acid is normally taken at dosages of 2 grams thrice every day for a total of 6 grams each day during the treatment period.

The condition of cardiomyopathy is also occasionally caused by a deficiency of the mineral selenium in the body of the affected individual. Keshan's disease is a form of cardiomyopathy caused by a deficiency of selenium in the body, this form of cardiomyopathy is commonly found in China, but is very uncommon in the United States and other western countries. In addition, except in the island nation of Taiwan, most comparative studies carried out on populations in different parts of the world other than mainland China have not supported a link between selenium deficiency and the development of DCM in people. Therefore in areas outside China, studies have not been carried out that using selenium as supplements to treat people down with DCM. Moreover, additionally there is no proof that supplements of selenium can help people with cardiomyopathy outside the Chinese mainland and Taiwan. Therefore the use of this particular mineral as a supplement in the treatment of the condition has remained a dead avenue for the treatment of cardiomyopathy in other countries.

The use of intravenous thiamine or vitamin B1 is followed by oral supplements of the vitamin is generally required in the small proportion of people suffering from cardiomyopathy, where the condition is caused by severe depletion of vitamin B1-thiamine, commonly known as wet beri beri. As far as other forms of cardiomyopathy are concerned, the use of vitamin B1 as a supplement does not appear to be helpful or effective in treatment. All treatment methodologies in people requiring supplements of vitamin B1 to treat cardiomyopathy must be done under medical supervisions, and furthermore the condition must first be identified and diagnosed as wet beri beri before treatment is begun.

The main complications during incidences of cardiomyopathy is congestive heart failure, and many medical doctors and the traditional experts in herbal medicine deem the use of the hawthorn to be an effective treatment option with the added benefit of being low key and risk free. While the use of the hawthorn with cardiomyopathy patients has still to be conducted on a large scale, many of the most rigorous and long term clinical trials conducted using the hawthorn for the treatment of the signs and symptoms of early-stage congestive heart failure have shown good results in all such patients. The use of 80 to 300 mg of standardized hawthorn leaves and flower extract two to three times each day of the treatment regimen in the clinical trials conducted on heart failure patients has shown good results.

The traditional form of medicine in India-Ayurveda makes the use of two herbs in the treatment of people suffering from cardiomyopathy and congestive heart failure; this has been supported in its efficacy to some extent by a small number of clinical studies carried out using the herbs in patients. One of the herbs is known as the Arjun-botanical name:Terminalia arjuna, this herb is known to be effective in significantly improving many of the signs and symptoms associated with cardiomyopathy, and has also been shown to have objective measurements in heart functioning. The extract of the arjun was taken at 500 mg doses by people with DCM and severe heart failure during the clinical trial thrice a day all through the treatment period. The first measurable effects were observed within the first two weeks, by observing a significant improvement in the heart function of patients, and furthermore for approximately two years improvements continued with regular supplementation in the long term study. The herbal extract was not standardized for any particular constituent even though the arjun used during this study was concentrated for effectiveness. The commercial forms and preparations of the herbal extract often come standardized to contain 1% arjunolic acid for use as an herbal supplement.

The second herb used in Ayurveda is the herb known as the coleus, this herb contains forskolin, which is a substance that can bring about the dilation of blood vessels and helps in improving the forcefulness with which the heart pump blood and the herb therefore has a bearing on the rate of circulation within the body. The use of this herb and its active ingredient has been shown in recent clinical studies to improve heart function in people affected with cardiomyopathy and also in those afflicted with the condition known as congestive heart failure as well. Furthermore the heart functioning in people afflicted with cardiomyopathy has shown improvement through the use of forskolin which also reduced blood pressure at the same time. The isolated forskolin was used intravenously during these trials. The effectiveness of the oral form of the coleus extract is still unknown and remains to be identified. The dosage levels of these herbs in the treatment of cardiomyopathy are still to be assessed through clinical trials, at the same time most doctors and herbal medicine practitioners recommend dosages of 200 to 600 mg of coleus extract containing 10% forskolin every day of the treatment regimen.

Another traditional herb called the dan shen-botanical name Salvia miltiorrhiza, has traditionally been used in the Chinese medical system to treat angina and coronary artery diseases in individuals afflicted with these diseases. The preventative role of the herb has been suggested by some studies, which suggest dan shen may improve the force of heart contractions and coronary circulation; such an action will lead to the prevention of damage to the heart muscles of the person. Clinical trials to treat DCM using dan shen have not been reported and these may yet show positive results as and when they are conducted. The recommended dosage of the herbs is 1 to 6 grams per day of the dried root, and this is the typical suggestion of Chinese medicine practitioners.

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