Advanced Heart and Lung Disease Center

Coronary artery disease begins when damage leads to the development of plaque building up within the artery wall. This plaque buildup begins to narrow the arteries carrying blood to the heart. As more plaque builds up, your artery has trouble supplying blood to your heart muscle when it needs it most. Plaque may tear, completely blocking the artery, or a blood clot may plug the narrowed opening. The decreased blood supply to the heart causes the heart muscle to become weak. Sometimes, the blockages can be opened up by placing a stent or balloon into the artery. Sometimes, the blockages must be surgically "bypassed" where new pathways for blood flow to the heart muscle are created. Sometimes, neither of these procedures is an option, and medications are used for management.

Cardiomyopathy describes any disorder that affects the heart muscle, causing the heart to lose its ability to pump blood effectively. In dilated cardiomyopathy, the heart muscle begins to stretch and becomes thinner. This can occur for a variety of reasons. Over time, the inside of the chamber enlarges or dilates. As the heart chambers dilate, the heart muscle doesn't contract normally and cannot pump blood very well. As the heart becomes weaker heart failure can occur. Common symptoms of heart failure include shortness of breath, fatigue and swelling of the ankles, feet, legs, abdomen and veins in the neck.

Hypertrophic cardiomyopathy is most often caused by abnormal genes in the heart muscle. These genes cause the walls of the heart chamber (left ventricle) to contract harder and become thicker than normal. The thickened walls become stiff. This reduces the amount of blood taken in and pumped out to the body with each heartbeat. Restrictive cardiomyopathy causes the heart's ventricles to become rigid because abnormal tissue, such as scar tissue, replaces the normal heart muscle. As a result, the ventricles can't relax normally and fill with blood, and the atria become enlarged. Blood flow in the heart is reduced over time. This can lead to problems such as heart failure or arrhythmias.

Similar to restrictive cardiomyopathy, infiltrative cardiomyopathy causes the heart's ventricles to become rigid because abnormal tissue replaces the normal heart muscle. As a result, the ventricles can't relax normally and fill with blood, and the atria become enlarged. Blood flow in the heart is reduced over time. This can lead to problems such as heart failure or arrhythmias. Amyloidosis is a disease in which abnormal proteins build up in the body's organs, including the heart. These abnormal proteins infiltrate the heart muscle and cause cardiomyopathy to occur. Hemochromatosis is a disease in which too much iron builds up in your body. The extra iron is toxic to the body and can damage the organs, including the heart. The excess iron deposits in the heart muscle and causes infiltrative cardiomyopathy.

In ischemic cardiomyopathy, a lack of blood supply to the heart muscle caused by coronary artery disease and heart attacks has resulted in a weak heart muscle. This decreases the heart's ability to pump blood and over time the heart becomes weaker. Eventually, heart failure can occur. Common symptoms of heart failure include shortness of breath, fatigue and swelling of the ankles, feet, legs, abdomen and veins in the neck.

There are four valves that regulate the flow of blood within the heart: two on the left side (the aortic and mitral valves) and two on the right side (the pulmonary and tricuspid valves). Heart valve disorders can be caused by leaking (insufficiently or regurgitation) of the valves or narrowing (stenosis) of the valves. ​When heart valves fail to open and close properly, the effects on the heart can be serious, possibly impairing the heart's ability to pump blood efficiently through the body. Heart valve problems are one cause of heart failure. Typically, valves can either be repaired or replaced through intervention or surgery. However, sometimes neither of these procedures are an option, and an evaluation for advanced heart failure therapies is warranted.

An irregular heartbeat is an arrhythmia. Some arrhythmias are life-threatening, and having heart failure increases the risk of developing these life-threatening arrhythmias. There are some medications and procedures that can be used to stop abnormal heartbeats from occurring, but sometimes the arrhythmia does not respond to the treatment. In these cases, advanced heart failure therapies may be necessary.