The difference between cardiomyopathy and coronary heart disease

Written by Li Hai Wen
Cardiology
Updated on January 11, 2025
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Cardiomyopathy refers to a type of disease characterized primarily by organic changes in the myocardium, such as dilated cardiomyopathy, hypertrophic cardiomyopathy, and restrictive cardiomyopathy. These diseases are characterized mainly by pathological changes in the myocardium itself, forming a category of heart diseases. In contrast, coronary heart disease often refers to a type of heart disease caused by the narrowing of the coronary arteries due to atherosclerosis, leading to insufficient blood supply to the heart. Cardiomyopathy often manifests as damage to the myocardium, while coronary heart disease often manifests as blockage of the blood vessels. This is the fundamental difference between these two categories of heart diseases.

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Written by Zhang Yue Mei
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Can people with cardiomyopathy run?

Whether a person with myocardial disease can run or not depends on the extent of myocardial damage and clinical symptoms. If the myocardial damage is severe and there are significant clinical symptoms of heart failure and arrhythmia, this group should not run and needs bed rest. If strenuous activity would worsen heart failure, the myocardial damage is mild, with no typical clinical symptoms, and does not affect daily activities, this group can engage in appropriate exercises like walking or running, but the duration should not be too long, about 20 to 30 minutes each time.

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Do you need to take medication for a long time for dilated cardiomyopathy?

Patients with dilated cardiomyopathy need long-term or even lifelong medication because dilated cardiomyopathy is an incurable disease that requires medication to properly control the onset of heart failure symptoms. The symptoms of heart failure due to dilated cardiomyopathy can easily recur, leading to repeated hospitalizations, often related to the patient's irregular medication use or arbitrary discontinuation of medication. Therefore, patients with dilated cardiomyopathy must take medication under a doctor's guidance for long periods, such as using diuretics and medication like sustained-release metoprolol, etc. At the same time, it is important to maintain good living habits, a low-salt diet, a good emotional state, and conduct moderate exercise under stable conditions.

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Written by Liu Ying
Cardiology
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Can dilated cardiomyopathy be inherited?

We say that dilated cardiomyopathy is a type of cardiomyopathy characterized by enlargement of the left ventricle or both ventricles, accompanied by systolic dysfunction. Some cases of dilated cardiomyopathy are familial, with the main inheritance patterns being autosomal dominant, X-linked recessive, and more rarely, mitochondrial inheritance. The cause of most dilated cardiomyopathies is unclear, but potential causes include infections, non-infectious inflammation, endocrine metabolic disorders, genetics, psychological trauma, and poisoning, including alcohol poisoning. Alcoholism is a common cause of dilated cardiomyopathy in China. Clinically, dilated cardiomyopathy presents with cardiac enlargement, heart failure, arrhythmias, thromboembolism, and sudden death.

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Written by Liu Yong
Cardiology
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Does cardiomyopathy require surgery?

Firstly, whether myocardial disease requires surgery, we need to clarify the type of myocardial disease and the stage of myocardial disease, that is, the stage of heart function that has been affected. There are many types of myocardial diseases, including dilated cardiomyopathy, ischemic cardiomyopathy, and restrictive cardiomyopathy, for instance. The treatment plans for different types of myocardial diseases are not exactly the same. For example, dilated cardiomyopathy is generally treated with medication, and only in the very late stages of dilated cardiomyopathy, or what is known as stage IV heart function, when conventional medication is ineffective, heart transplantation might be considered if a donor is available and conditions allow. However, currently, heart donors are extremely rare, making this option quite difficult to achieve. The latest advances in clinical research have introduced artificial mechanical hearts available for transplantation, but the costs of surgery are very high, and the technology is not very mature yet. Therefore, the chances and opportunities for surgery are not very great and must be decided based on the situation. For other conditions, such as ischemic cardiomyopathy, if it is clearly caused by severe ischemia, we might consider addressing the factors causing myocardial ischemia, such as performing a coronary angiography. If there is severe coronary artery stenosis, we might consider implementing a coronary artery stent or coronary artery bypass grafting to alleviate the ischemic factors. In cases like restrictive cardiomyopathy, if there are severe restrictive factors contributing to the disease, surgical treatment might also be pursued.

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How to recover from decreased physical fitness due to dilated cardiomyopathy?

Dilated cardiomyopathy is diagnosed after excluding conditions such as hyperthyroidism, hypertension, coronary heart disease, cardiac hypertrophy, or myocarditis as underlying causes. Generally, the exact cause of dilated cardiomyopathy is unknown, rendering causal treatment impossible. Once diagnosed with dilated cardiomyopathy, it is impossible to completely cure the condition. The only approach is to manage symptoms and prevent further progression of the disease. Typically, this involves the use of beta-blockers, ACE inhibitors, and diuretics. If the patient has severe cardiac dysfunction, drugs like digoxin, which strengthen heart function, may be considered. If medication does not adequately control the condition, other treatments like CRT might be considered, as well as the use of phosphodiesterase inhibitors, diuretics, or intravenous cardiotonic glycosides.