Treating cardiomyopathy in children

Treatment for cardiomyopathy aims to reduce and manage any symptoms and reduce the chance of any complications. Treatment depends on the type of cardiomyopathy someone has and, importantly, what symptoms they have. Someone with no symptoms, may not have any treatment. But people who are having symptoms, will have treatment tailored to them.

Your child might be offered one or more of the following, depending on their symptoms.

Medication

  • ACE inhibitors (angiotensin-converting enzyme inhibitor) reduce the demand on the heart and make it easier for the heart to pump.
  • Angiotensin II receptor blockers (ARBs) reduce the demand on the heart and make it easier for the heart to pump. They may be used instead of ACE inhibitors.
  • Anti-arrhythmic medication control the heart’s rhythm and correct arrhythmias (abnormal heart rhythms).
  • Anticoagulants (‘blood thinners’) prevent blood clots forming, and are used for people with atrial fibrillation (an abnormal heart rhythm which causes uneven blood flow through the heart).
  • Beta-blockers reduce the workload on the heart, and can help with chest pain, breathlessness and palpitations.
  • Calcium channel blockers reduce the force of the heart’s contraction. Some lower blood pressure by reducing the stiffness of the arteries, and others reduce chest pain and arrhythmias.
  • Diuretics (‘water tablets’) reduce fluid build-up (oedema) by getting rid of water as urine. They also lower blood pressure.

Devices and surgery

Device. Copyright Boston Scientific

  • Pacemakers control the heart’s rhythm by constant electrical stimulation of the heart. This ensures that the heart is beating normally (called ‘sinus rhythm’). Some pacemakers, called biventricular pacemakers, used in cardiac resynchronisation therapy, send electrical signals to both sides of the heart to help both sides to beat together.
  • ICDs (implantable cardioverter defibrillators) monitor the heart’s rhythm and, if a dangerous arrhythmia occurs, shock the heart back into a normal rhythm. Some ICDs are also pacemakers.
  • Left ventricular assist device (or LVAD) are artificial pumps which assist the heart to pump blood. LVADs are only used for people who have very severe heart function problems, while they are waiting for a heart transplant.
  • Surgery might be used for people with hypertrophic cardiomyopathy where the thickened heart muscle obstructs blood flow out of the heart. This obstruction may be surgically reduced either by injecting medical alcohol into the area of thickening to chemically reduce it (called alcohol septal ablation) or using surgery to cut away some of the thickening (called surgical myectomy).
  • In a small number of cases, a heart transplant might be needed. This would be if the heart is functioning so poorly that it cannot support the body’s needs. They are more likely in children with
    restrictive cardiomyopathy than in other types of cardiomyopathy. However, heart transplants are rare, and most children will not need one.

*Device image provided courtesy of Boston Scientific. © 2017 Boston Scientific Corporation or its affiliates. All rights reserved.

©Cardiomyopathy UK. May 2017.