arrhythmogenic

Cardiomyopathy is the name for diseases of the heart muscle. These diseases enlarge your heart muscle or make it thicker and more rigid than normal. In rare cases, scar tissue replaces the muscle tissue.

Some people live long, healthy lives with cardiomyopathy. Some people don't even realize they have it. In others, however, it can make the heart less able to pump blood through the body. This can cause serious complications, including:

• Heart failure
• Abnormal heart rhythms
• Heart valve problems
• Sudden cardiac arrest (SCA)

Heart attacks, high blood pressure, infections, and other diseases can all cause cardiomyopathy. Some types of cardiomyopathy run in families. In many people, however, the cause is unknown. Treatment might involve medicines, surgery, other medical procedures, and lifestyle changes.

NIH: National Heart, Lung, and Blood Institute

An arrhythmia is a problem with the rate or rhythm of your heartbeat. Your heart beats too quickly, too slowly, or with an irregular pattern. Changes in the electrical signals that control your heartbeat cause arrhythmias.

• When your heart beats faster than normal, it's called tachycardia.
• When your heart beats too slowly, it's called bradycardia.
• When the signal to beat comes too early, it's called a premature or extra heartbeat. It may feel like your heart skipped a beat.

There are many types of arrhythmias. Arrhythmias may affect the upper or lower chamber of your heart. The most common type of arrhythmia is atrial fibrillation, which causes an irregular and fast heartbeat.

Some arrhythmias are harmless, such as when your heart rate speeds up during exercise and slows down when you sleep. But if you have a frequent irregular rhythm, it may mean your heart isn't pumping enough blood into your body. Getting treatment and following a heart-healthy lifestyle can help control arrhythmias. It may also help prevent heart damage that can trigger some heart arrhythmias.

Many factors can affect your heart's rhythm, such as having had a heart attack, smoking, congenital heart defects, and stress. Other factors that could increase your risk for some types of arrhythmias could include if you:

• Have a family history of arrhythmias.
• Have certain health conditions, which can include heart and blood vessel diseases, lung diseases, kidney diseases, obesity, and sleep apnea.
• Are an older adult.
• Have had recent surgery for your heart, lungs, or throat.
• Take certain medicines for other health conditions.
• Use illegal drugs.

If you have risk factors, some situations that make your heart work harder, raise your blood pressure, or cause strong emotional stress may trigger an arrhythmia.

You may not have any noticeable symptoms of an arrhythmia. Your provider may find an arrhythmia during your routine checkup. Symptoms of an arrhythmia can include:

• Fast or slow heartbeat
• Skipping, fluttering, or pounding heartbeats
• Chest pain or discomfort
• Dizziness or fainting
• Shortness of breath
• Sweating
• Tiredness or weakness

Seek emergency medical care if you have chest pain, shortness of breath, or think you are having a heart attack.

To find out if you have an arrhythmia, your health care provider may order an electrocardiogram (EKG). This test records your heart's electrical activity and is the most common for finding an arrhythmia. Your provider may also:

• Ask about your medical history, including your symptoms and lifestyle habits.
• Do a physical exam, which includes checking your heartbeat and pulse.
• Order blood tests and other heart tests.
• Check your legs or feet for swelling.
• Look for signs of other health conditions that could cause an arrythmia, such as thyroid disease.

Treatment may include medicines, an implantable cardioverter-defibrillator (ICD) or pacemaker, or sometimes surgery. Your provider may also recommend avoiding activities that may trigger your arrhythmia.

The goal of treatment is to restore a normal heart rhythm. If not treated, arrhythmias can damage your heart, brain, and other organs and could be life-threatening.

To help prevent an arrhythmia, your provider may suggest that you make heart-healthy lifestyle changes and treat health conditions that may cause arrhythmias.

NIH: National Heart, Lung, and Blood Institute

Congenital heart defects (CHDs) are problems with the structure of the heart. "Congenital" means that that the problems are present at birth. These defects happen when a fetus's heart doesn't develop normally during pregnancy. Congenital heart defects are the most common type of birth defect.

Congenital heart defects can change the way the heart pumps blood. They may make blood flow too slowly, go the wrong way, or block it completely.

There are many types of congenital heart defects. They can happen in one or more parts of the heart. The most common types are:

• Septal defects ("hole in the heart") - openings in the wall between the left and right sides of the heart
• Heart valve defects - problems with the valves that control the flow of blood through the heart
• Defects in the large blood vessels that carry blood in and out of the heart

Congenital heart defects can range from very mild problems that never need treatment to life-threatening problems at birth. The most serious congenital heart defects are called critical congenital heart disease. Babies with these defects usually need surgery in the first year of life. But the symptoms of milder heart defects may not show up until childhood or adulthood.

Researchers often don't know what causes congenital heart defects. They do know that changes in a baby's genes sometimes cause a heart defect. The changed genes may come from the parents, or the changes may happen during pregnancy.

Several things may increase the chance that your baby has a congenital heart defect, such as:

• Your health before and during pregnancy, including:
  • Having diabetes before pregnancy or developing it in the first 3 months of pregnancy (diabetes that develops later in pregnancy isn't a major risk for heart defects). Carefully controlling your blood glucose, also called blood sugar, before and during pregnancy can lower your baby's risk of congenital heart defects.
  • Having phenylketonuria (PKU), a rare inherited disorder that affects how the body uses a protein in foods. If you have PKU, eating a low-protein diet before getting pregnant can lower your baby's risk of having a congenital heart defect.
  • Having rubella (German measles) during pregnancy.
• Your contact with certain substances during pregnancy, including:
  • Smoking or secondhand smoke (breathing smoke from another smoker).
  • Certain medicines, such as angiotensin-converting (ACE) inhibitors for high blood pressure and retinoic acids for acne. If you're pregnant or plan to get pregnant, talk with your health care provider about all the medicines you take.
• Your family history and genetics. In most cases, congenital heart defects don't run in families. But your chance of having a baby with a congenital heart defect does go up if you or the other parent has a congenital heart defect, or if you already have a child with a congenital heart defect.

Congenital heart defects don't cause pain. The signs and symptoms are different, depending on the type and number of defects and how serious they are.

Common signs and symptoms of congenital heart defects include:

• Cyanosis - a bluish color to the skin, lips, and fingernails. It happens when there isn't enough oxygen in the blood.
• Fatigue - your baby may be unusually sleepy and may become very tired during feedings.
• Poor blood flow.
• Fast or difficult breathing.
• Heart murmur - an unusual sound between heartbeats.

Congenital heart defects don't always cause other problems. If they do, which problems you have would depend on the type and number of defects and how serious the defects are.

Children with congenital heart defects are more likely to:

• Be smaller than other children
• Have problems or delays in mental, and emotional growth, and behavior, such as:
  • Speech and language problems
  • Attention deficit hyperactivity disorder (ADHD)

People with congenital heart defects may develop other health conditions, including:

• Endocarditis - an infection of lining of the heart and valves
• Arrhythmia - a problem with the rate or rhythm of your heartbeat
• Heart failure - when your heart can't pump enough blood to the body
• Pulmonary hypertension - high blood pressure in your lungs
• Kidney and liver disease

• Before a baby is born, your provider may use ultrasound pictures of the fetus's heart to look for heart defects. This is called a fetal echocardiogram. It's done between weeks 18 and 22 of pregnancy.
• During the first few days after birth, all newborns are checked for congenital heart defects. A pulse oximeter is clipped to your baby's hands or feet to measure blood oxygen. If it shows low levels of blood oxygen, more tests will be needed to find out if your baby has a heart defect.
• To diagnose congenital heart defects in babies, children, and adults, a provider may use many tools, including:
  • A physical exam.
  • Certain heart tests to see how the heart is working.
  • Genetic testing to see if certain gene problems caused the defect.

Treatment depends on the type of congenital heart defect and how serious it is. Possible treatments include:

• Cardiac catheterization to repair simple defects, such as a small hole in the inside wall of the heart. A catheterization uses a thin tube guided through a vein and into the heart.
• Heart surgery may be needed to:
  • Repair defects in the heart and blood vessels.
  • Repair or replace a heart valve.
  • Place a device in the chest to help the heart pump blood.
  • Do a heart transplant
• Medicine is often used if your baby has a specific type of congenital heart defect called patent ductus arteriosus.

All children and adults who have congenital heart defects need regular follow-up care from a cardiologist (a doctor who specializes in heart diseases) throughout their life, even if their defect was repaired.

Some people may need several heart surgeries or catheterizations over the years. They may also need to take medicines to help their hearts work as well as possible.

NIH: National Heart, Lung, and Blood Institute