Cardiomyopathy medical therapy

Cardiomyopathy Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Cardiomyopathy from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Guidelines
2023 ESC Guideline Recommendations
2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy
Case Studies
Case #1
Cardiomyopathy medical therapy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Cardiomyopathy medical therapy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Cardiomyopathy medical therapy
CDC on Cardiomyopathy medical therapy
Cardiomyopathy medical therapy in the news
Blogs on Cardiomyopathy medical therapy
Directions to Hospitals Treating Cardiomyopathy
Risk calculators and risk factors for Cardiomyopathy medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Treatment depends on the type of cardiomyopathy, but may include medication, implanted pacemakers, defribillators, or ventricular assist devices (LVADs), or ablation. The goal of treatment is often symptom relief, and some patients may eventually require a heart transplant. Treatment of cardiomyopathy (and other heart diseases) using alternative methods such as stem cell therapy is commercially available but is not supported by convincing evidence.

Medical Therapy

Medications may be prescribed for the following reasons:

• Lower the blood pressure. ACE inhibitors, angiotensin II receptor blockers, beta blockers, and calcium channel blockers are examples of medicines that lower blood pressure.
• Slow the heart rate. Beta blockers, calcium channel blockers, and digoxin are examples of medicines that slow the heart rate. Beta blockers and calcium channel blockers also are used to lower blood pressure.
• Keep the heart beating with a normal rhythm. These medicines, called antiarrhythmics, help prevent arrhythmias.
• Balance electrolytes in the body. Electrolytes are minerals that help maintain fluid levels and acid-base balance in the body. They also help muscle and nerve tissues work properly. Abnormal electrolyte levels may be a sign of dehydration (lack of fluid in your body), heart failure, high blood pressure, or other disorders. Aldosterone blockers are an example of a medicine used to balance electrolytes.
• Remove excess fluid and sodium from the body. Diuretics, or "water pills," are an example of a medicine that helps remove excess fluid and sodium from the body.
• Prevent blood clots from forming. Anticoagulants, or "blood thinners," are an example of a medicine that prevents blood clots. Blood thinners often are used to treat blood clots in people who have dilated cardiomyopathy.
• Reduce inflammation. Corticosteroids are an example of a medicine used to reduce inflammation.

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death - Infiltrative Cardiomyopathies (DO NOT EDIT)

AHA/ACC 2017 Class 1 recommendation: The clinical strategy of inhibition of the renin-angiotensin system with ACE inhibitors (Level of Evidence: A), OR ARBs (Level of Evidence: A), OR ARNI (Level of Evidence: B-R)138 in conjunction with evidence-based beta blockers, and aldosterone antagonists in selected patients is recommended for patients with chronic HFrEF to reduce morbidity and mortality.

AHA/ACC 2017 guidelines: Class 2a recommendation, Level of Evidence: B-R: Ivabradine can be beneficial to reduce HF hospitalization for patients with symptomatic (NYHA class II-III) stable chronic HFrEF (LVEF ≤35%) who are receiving GDEM*, including a beta blocker at maximum tolerated dose, and who are in sinus rhythm with a heart rate of 70 bpm or greater at rest.

AHA/ACC 2017 guidelines: Class 1 recommendation, Level of Evidence: B: Systolic and diastolic blood pressure should be controlled in patients with HFpEF in accordance with published clinical practice guidelines to prevent morbidity

References

Yancy CW, Jessup M, Bozkurt B1, Butler J1, Casey DE Jr1, Colvin MM1, Drazner MH1, Filippatos GS1, Fonarow GC1, Givertz MM1, Hollenberg SM1, Lindenfeld J1, Masoudi FA1, McBride PE1, Peterson PN1, Stevenson LW1, Westlake C1: 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2017 Aug 8;136(6):e137-e161.

1. WRITING COMMITTEE MEMBERS, Yancy CW, Jessup M, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 2013; 128:e240.