Viral Cardiomyopathy

[Angie011764]

Is viral cardiomyopathy reversible?  

I am 49 years old and 10 months ago I was diagnosed with viral cardiomyopathy.  I have been on medication (beta blockers and ace inhibitors) and my cardiologist has told me I will be on my target dose medication for the rest of my life.  When I was diagnosed with viral cardiomyopathy my EF was 20.  I have dropped some weight and walk every day.  When I was diagnosed was because I landed in the ER as I was short of breath, had an uncontrolable cough, and felt my lungs filled with fluid.  I thought I had pneumonia, but when I got the very unexpected news that it was heart failure I felt like I had been handed a death sentence.  I immediately read about it and was sad to learn about it's high mortality and morbidity rate.  I feel very blessed that I am, besides my cold/flu-like symtoms leading up to my diagnosis, I am pretty asymtomatic.  I guess my question is, if I continue to watch my sodium intake, manage my weight to a healthy weight, and walk an hour and a half a day, is there a possibility that my condition can be reversed?  Thank you!

[mkb_devildog]

A related discussion, congestive heart failure was started.

[Angie011764]

After walking for 2 miles at a 3.3 speed rate on a treadmill, average heart rate 76 with a high of 207.  After walking for an hour in the evening my average heart rate was 108 with a high of 229.  Can you tell me what these numbers mean?  Is my heart rate low?  High?  Normal for the type and length of activity?  Normal for my condition?  Thanks!

[Angie011764]

Dear Dr. Rich,

I have started an exercise regime which consists of walking on a treadmill at a 3.3 rate for 30 minutes at 1:20 p.m. and for one 1 full hour 6:30 p.m. - 7:30 p.m. Monday through Friday.  I feel great, I don't get tired or out of breath, so I am listening to my body and am enjoying it.  I notice at the end of each session I get a summary which states that my average heart rate is 101 and the highest high rate is 237.  Is that alarming?  Again, I feel great, I don't feel out of breath or tired.  I just didn't know if it is "normal" that my heart rate reaches 237 and drops to 91 with the average heart rate being 101 and on some occasions 132 is the average.  I walk for an hour and a half Monday through Friday and I take Saturday and Sunday off.  I gained a pound in that week.  :(

Best regards,

[Jonathan D. Rich, MD]

I agree with your comments.  Exercise is a good thing and I would encourage it.  However, always "listen to your body"---pushing yourself too much is not advisable but many patients with heart conditions are able to work out regularly and I think this is great.

And educating yourself is absolutely the right thing to do.  This coupled with being under the care of physicians who you trust and you cant go wrong!

All the best,

Dr. Rich

[Angie011764]

Dr. Rich,

Thank you for responding to my question.  It appears that there might be some differences in medical opinions which I'm sure it is not that that uncommon.  I'm glad to hear that there are some cardiomyopathies that are reversable.  I don't think I will ever be 100% well, but I do think viral cardiomyopathy is at least treatable.  Again, I am lucky to be asymptomatic.  I have just bought a membership to the gym so weather is not a deterrent and I can walk in a climate-controlled environment.  I am determined to shed 64 pounds to reach a healthy weight.  The easier I go on my heart the better right?  Also, I am a firm believer that the heart muscle is just like any other muscle to an extent and if I walk regularly to make my heart muscle stronger then I should see results and those results should show by an increased EF level.  :)

In the interim, I have ordered four books on cardiomyopathy so I can educate myself better on my condition.  I think knowledge is power and the more I know about it, the better I can fight it.  Please feel free to tell me if there is something I am missing.  Comments are always welcomed and constructive criticism is always well-taken.

[Jonathan D. Rich, MD]

Hello and welcome to the forum.

I am sorry to hear about what you have been going through but I am also glad that you are on a good medical regimen and feeling well.  This is critical.

Your question is a little tricky for a couple of reasons.  First, many patients are diagnosed with a "viral cardiomyopathy" because there is no other apparent reason for the cardiomyopathy/heart failure.  Sometimes a virus is indeed responsible but for many other cases, the cause is likely unknown or potentially even genetic. But, this is probably not all that important because the reality is that some cardiomyopathies do get better and will even completely reverse.  Others will not imrpove quite as much but as long as the patient is on excellent medical therapy, the condition can remain at bay for quite a long time. Remember, patients with diabetes do not ever truly "recover" from their condition but as long as they take their insulin, etc they can live with the diabetes without too many problems...the same can be said for many cardiomyopathies.

It sounds like you are committed to doing whatever it takes to ensure for yourself the best chance at a favorable outcome and this is exactly what you need to be doing.  You should live an active, yet healthy lifestyle, take your medications as instructed, follow up with your doctors, and then most importantly, go live your life and enjoy it!!

Wishing you only the best,

Dr. Rich