Heart Muscle Disease - Diagnosis

Heart muscle disease: what is it?

If the heart muscle is diseased and no longer functions properly, the heart chambers can no longer perform their normal contraction capacity and supply the body with sufficient blood, i.e. with oxygen and nutrients. Heart muscle diseases can therefore lead to increasing cardiac insufficiency and, as a result, to cardiac arrhythmias up to and including sudden cardiac death.

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• What types of diseases are there?
• What are the symptoms?
• How is the diagnosis made?
• How is heart muscle disease treated?
• Whom can I ask?
• How are the costs going to be covered?

What types of diseases are there?

Although the classification cannot always be precisely defined or the transitions between individual forms of disease can be fluid, a distinction is made between two large groups of heart muscle diseases:

• Inflammatory diseases of the heart muscle (myocarditis): They can result from infections or non-infectious triggers such as other diseases or certain toxins. In some cases, myocarditis occurs without an apparent cause (“idiopathic”).
• Non-inflammatory changes in the heart muscle (cardiomyopathies): They are either hereditary or are mainly caused by infections, metabolic diseases or poisons (e.g. alcohol abuse or the use of certain medications). If the cause is unknown, one speaks of primary (idiopathic) cardiomyopathies, and if the cause is known, it is called secondary (specific) cardiomyopathies. These specific forms occur as a result of certain other illnesses, for example heart valve defects, circulatory disorders, untreated high blood pressure or as a result of myocardial inflammation. These forms can be better prevented. They are also easier to treat.

Primary and secondary cardiomyopathies are divided into the following forms according to their respective form or design:

• Dilated cardiomypathy (DCM),
• hypertrophic cardiomyopathy (HCM),
• restrictive cardiomyopathy (RCM),
• arrhythmogenic right ventricular cardiomyopathy (ARVC).

What are the symptoms?

Depending on the form and severity of the heart muscle disease, the symptoms can range from mild, barely noticeable impairments such as low resilience, fatigue, shortness of breath or leg edema, cardiac arrhythmia, symptoms of increasing heart failure and angina pectoris to life-threatening conditions such as sudden heart failure. The formation of blood clots can lead to strokes and pulmonary embolisms, for example.

How is the diagnosis made?

In addition to a detailed medical history, a physical exam is required. Further examinations usually follow, especially:

• Laboratory examination,
• ECG and possibly long-term ECG,
• Cardiac ultrasound,
• Chest x-ray,
• Cardiac catheter examination - if necessary with taking a tissue sample (heart muscle biopsy). To do this, a catheter is inserted through a large vein (e.g. in the groin) and advanced through the venous system into the heart. Here a small amount of tissue is removed with small forceps. Local anesthesia at the entry point of the catheter is usually sufficient.

How is heart muscle disease treated?

The therapy depends on the underlying disease and the present heart muscle disease. Usually drugs are used to treat heart failure or cardiac arrhythmias. In severe cases, implantation of a special pacemaker and / or implantable defibrillator or a heart transplant can be considered.

Whom can I ask?

To clarify diseases of the heart muscles, you can contact the following offices:

• General Practitioner,
• Specialist in internal medicine with an additional subject in cardiology.

How are the costs going to be covered?

All necessary and appropriate diagnostic and therapeutic measures are taken over by the health insurance carriers. Your doctor or the outpatient clinic will generally settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For more information, see Costs and Deductibles.

When hospitalization is required

Hospitalization may sometimes be required for treatment. The hospital costs are billed for. The patient has to pay a daily contribution to the costs. Further medication treatment at home takes place by prescription from the general practitioner or specialist.

For more information, see What does a hospital stay cost?