Cardiomyopathy can be classified as primary or secondary. Primary cardiomyopathy can’t be attributed to a specific cause, such as high blood pressure, heart valve disease, artery diseases or congenital heart defects. Secondary cardiomyopathy is due to specific causes. It’s often associated with diseases involving other organs as well as the heart.
There are three main types of cardiomyopathy: dilated, hypertrophic and restrictive.
Claudication is a symptom of peripheral vascular disease, involving discomfort or pain in your legs that happens when you walk and goes away when you rest. You may not always feel pain; instead you may feel a tightness, heaviness, cramping, or weakness in one or both of your legs. Claudication often occurs more quickly if you walk uphill or up a flight of stairs. Over time, you may feel claudication at shorter walking distances, as the degree of artery blockage worsens.
heart attack occurs when the blood supply to part of the heart muscle itself — the myocardium — is severely reduced or stopped. The reduction or stoppage happens when one or more of the coronary arteries supplying blood to the heart muscle are blocked. This is usually caused by the buildup of plaque (deposits of fat-like substances), a process called atherosclerosis. The plaque can eventually burst, tear or rupture, creating a “snag” where a blood clot forms and blocks the artery. This leads to a heart attack.
Coronary Artery Disease
Coronary artery disease (CAD) occurs when the arteries that supply blood to the heart muscle (the coronary arteries) become hardened and narrowed. The arteries harden and narrow due to buildup of a material called plaque (plak) on their inner walls. The buildup of plaque is known as atherosclerosis (ATH-er-o-skler-O-sis). As the plaque increases in size, the insides of the coronary arteries get narrower and less blood can flow through them. Eventually, blood flow to the heart muscle is reduced, and, because blood carries much-needed oxygen, the heart muscle is not able to receive the amount of oxygen it needs. Reduced or cutoff blood flow and oxygen supply to the heart muscle can result in:
- Angina (AN-ji-na or an-JI-na). Angina is chest pain or discomfort that occurs when the heart does not get enough blood.
- Heart attack A heart attack happens when a blood clot develops at the site of plaque in a coronary artery and suddenly cuts off most or all blood supply to that part of the heart muscle. Cells in the heart muscle begin to die if they do not receive enough oxygen-rich blood. This can cause permanent damage to the heart muscle.
Over time, CAD can weaken the heart muscle and contribute to:
- Heart failure In heart failure, the heart can’t pump blood effectively to the rest of the body. Heart failure does not mean that the heart has stopped or is about to stop. Instead, it means that the heart is failing to pump blood the way that it should.
- Arrhythmias (a-RITH-me-as). Arrhythmias are changes in the normal beating rhythm of the heart. Some can be quite serious.
CAD is the most common type of heart disease. It is the leading cause of death in the United States in both men and women.
Peripheral Artery Disease
Peripheral artery disease (PAD) is a condition whereby fatty deposits build in the inner linings of the artery walls. The blockages restrict blood circulation, primarily in the arteries leading to the kidneys, stomach, arms, legs and feet.
Diagnosing PAD may be done with:
- An abnormal ratio between the blood pressure of the ankle and arm (ankle/brachial index, or ABI)
- A Doppler ultrasound exam of an extremity
- Angiography of the arteries in the legs (arteriography)
- Intravascular ultrasound (IVUS) of the extremity
- An MRI scan
For more patients, PAD can be treated with lifestyle changes including smoking cessation, controlling diabetes and blood pressure, more physical activity, a low-cholesterol and a low-saturated fat diet. Some patients require medications to improve their ability to walk longer distances, antiplatelet agents or cholesterol-lowering agents. In some cases, angioplasty or surgery is necessary.
Peripheral Vascular Disease
Peripheral vascular diseases are those related to the blood vessels outside the heart and brain. Often they are the narrowing of vessels carrying blood to the legs, arms, stomach or kidneys, i.e., “hardening of the arteries.” There are two categories of these circulation problems: functional and organic.
Functional peripheral vascular diseases don’t have an organic cause. That is, the blood vessels aren’t defective. Usually, the effects are short term, related to a spasm, and come and go. They may be triggered by cold, emotional stress, working with vibrating machinery or smoking.
Organic peripheral vascular diseases result from structural changes in the blood vessels, such as inflammation or damage to the tissues.
Claudication is discomfort or pain in your legs that happens when you walk and goes away when you rest. You may not always feel pain; instead you may feel a tightness, heaviness, cramping, or weakness in one or both of your legs. Claudication often occurs more quickly if you walk uphill or up a flight of stairs. Over time, you may feel claudication at shorter walking distances, as the degree of artery blockage worsens.