High Blood Pressure and Cardiomyopathy

[sophie]

I recently underwent a series of test: echo, ekg, stress test, and heart cath.  My doctor said I have dilated cardiomyopathy with an EF of 40% and left bundle branch block.  I have been receiving treatment for high blood pressure for several months.  I am currently taking atacand 16mg twice a day, clonidine .2mg three times a day, hydrochlorothiazide 25 mg once a day, norvasc 5 mg once a day, and K-DUR.  My blood pressure is still not under control.  My question is how much relation is there to the cardiomyopathy and my blood pressure?  If my blood pressure is ever under control will the cardiomyopathy improve?  What are the risks that the cardiomyopathy will worsen?  Is it normal for blood pressure to be so resistant to mediciation?  There are others we have tried (lopressor, cardizem, to name a few) with no results.  I am 53woman and slightly overweight.  My doctor says my blood work looks like a 20 year old (no problems).  My father died of a heart atttack at 47 and there is a history of much heart disease in my family.
Thanks so much for responding to my concerns.

[Cleveland Clinic, MD]

Dear Sue,

Thank you for your question. Basically cardiomyopathy is a "weakness" of the heart muscle that can be due to chronic, long-standing high blood pressure, ischemia (lack of blood flow - the most common), viral (more common in young people),  alcohol abuse, infiltrative diseases such as amalyoid or sacroid, pregnancy, idiopathic (unknown cause but probably viral) and several other rare conditions.  It is usually diagnosed by history and an echocardiogram.  Occasionally a heart muscle biopsy is performed.  It may not be easy to predict or diagnosis prior to the onset.

Symptoms are shortness of breath, swelling in the legs, chest discomfort and palpitations and increased fatigue.  Treatment is usually medical and in severe cases heart transplant.  About a third of patients get worse with some going on to transplant.  Another third stay the same and are managed well with medical therapy and the rest get better.  

With cardiomyopathy due to high blood pressure the treatment is lowering of the blood pressure.  Hypertension can be very resistant to medications and sometimes causes such as renal artery stenosis must be looked for in these cases.  Cardiomyopathy may improve slightly with good blood pressure control but does not usually return to normal.  Hope this information helps answer your questions.  Best wishes.

[Ron Herd]

Currently I have been experiencing what I call a high pulse rate.
When sitting with no activity my pulse rate sometimes goes up to 107, with Systolic of around 130 and a diastolic in the mid 80's.
I have cut out all tea coffee etc do not smoke .  Last nite  my reading  were sys 150 dia 104 pulse dropped to mid 80's.  I recently , had a physical with accompanying blood test including
thyroid with all tests in order.  Also electric cardiogram was normal. Should I be worried.  I am going again to the Dr again tommorrow.  
Thank you for your review


Ron Herd

[MED HELP INTERNATIONAL]

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[debi debruyn]

My mom is 62 and has been treated for high blood pressure for several years quite successfully.  In the last few weeks her blood pressure spiked quite a bit...over the weekend she had a dizzy spell that scared her enough to go to the ER.  All initial tests came back normal and she was referred to an internist.  She met with him this morning.  He did an ultrasound, says she has an enlarged heart and aorta.  He sent her home and told her to double her medicine for a week and come back.  He also said that the biggest risk is an anuryism.  That concerned her because her mom and brother both died suddenly.  Does this courst of treatment sound right or do we need to get another opinion?  Help!  Thank you so much for your time.

[annie]

MY MOTHER HAD 70 PERCENT MUSCLE DAMAGE AND IS STILL LIVING WHAT CAN I EXPECT

[Tony]

THIS IS MAINLY TO SUE GARLAND, I HAVE HOCM AND I HAVE ALSO HAD VERY HIGH BLOOD PRESSURE AND MY PROBLEMS THAT I WAS HAVING GOT UNDER CONTROL. CURENTTLY I AM ON LOWPRESSOR.
I JUST WENT THROUGH A SURGERY LATELY AND IT REALLY DID A LOT OF GOOD FOR ME.  IF ANY DOCTORS ASK YOU IF YOU WOULD LIKE TO HAVE AN HEART TRANSPLANT, OR CUTTING OUT ANYTHING; WELL I SAID "NO THAT I DID NOT WANT ANY SCARS TO BE SEEN BY ANYBODY", SO I ASK FOR ANY OTHER WAY THAT SOMETHING COULD BE DONE AND THE DOCTORS TOLD ME ABOUT ALCOHOL ABLATION SURGERY AND THAT IS WHAT I ENDED UP DOING. BEFORE I GOT THIS SURGERY DONE I COULD NOT EVEN WALK TO THE FRONT DOOR FROM MY ROOM WITHOUT MY HEART HURTING AND NOW THAT I HAD THE SURGERY I CAN RUN AROUND MY BLOCK A COUPLE OF TIMES AND WHEN I FELL LIKE STILL RUNNING I CAN. I ALSO AM DOING FULL CONTACT MARSHALL ARTS. SO I SAY IF YOU ARE GOING TO GET A SURGERY DONE GO FOR THE ALCOHOL ABLATION.

                                       SINCERELY,
                                           TONY

[EP__]

Sue, dilated cardiomyopathy is an endpoint to several other medical conditions.  If you had chronic hypertension before the myocardial dysfunction, your problem may very well be thickened and hardened arteries (ie. renal stenosis).  These problems could lead to eventuall heart failure if proper measures are not taken.  Attempt to regulate your diet and you may want to look into a radionuclide ventriculogram and maybe an angeoplasty.