Cardiomyopathy: Why even the young and fit are at heart risk
Being healthy doesn't prevent all heart conditions, especially those that are structural or genetic in origin
It often comes as a shock when a young, physically active individual with no apparent health issues is diagnosed with a serious heart condition. Most people assume that being fit, active and eating well keeps the heart in great shape. But certain heart conditions, such as cardiomyopathy, can develop silently, and even in individuals who appear to be in good health.
Being fit doesn’t prevent all heart conditions, especially those that are structural or genetic in origin. Dr Geetesh Govil, consultant-cardiology at Manipal Hospitals, Ghaziabad, Uttar Pradesh, explains.
WHAT IS CARDIOMYOPATHY?
Cardiomyopathy is a disease that causes stiffened, enlarged or thickened heart muscles, which can scar the tissue and affect its ability to pump blood efficiently. As a result, people may experience fatigue, shortness of breath or palpitations. These changes in the heart muscle can also be driven by underlying conditions, such as heart inflammation, infections affecting the heart, autoimmune disorders, diabetes or high cholesterol—factors that may not always be immediately visible but can gradually impact heart function.
WHY IT HITS THE YOUNG TOO
Cardiomyopathy in young, healthy individuals is often linked to genetic predisposition, especially inherited conditions, such as hypertrophic cardiomyopathy, which remain undetected until symptoms appear. Viral infections can also trigger inflammation of the heart muscle (myocarditis), which may later progress to cardiomyopathy. Additionally, autoimmune responses and idiopathic causes play a role in some cases. In athletes, intense physical training may mask underlying structural heart abnormalities, which can become risky under strain.
OTHER RISK FACTORS
Some underlying conditions and life events can quietly raise the risk:
- Family history: A family history can point to an inherited weakness in the heart muscle that may show up over time.
- Personal history: Previous damage to the heart can leave the muscle weaker over time.
- Long-term use of alcohol or substance abuse: Prolonged use can slowly damage heart muscles and affect functions.
- Stress: Intense emotional stress can temporarily affect the heart.
- Radiation or chemotherapy: These treatments can sometimes impact heart muscles over time.
- BMI higher than 30: Excess weight can put continuous strain on the heart.
HOW TO TREAT CARDIOMYOPATHY
Cardiomyopathy often develops without clear early signs and is usually identified through tests such as CT scans, echocardiograms and electrocardiogram, which help detect changes in the structure and functioning of the heart. In some cases, further imaging or genetic testing is done to understand the cause.
In the early stages, devices such as pacemakers, implantable defibrillators and cardiac resynchronisation therapy (CRT) are used to regulate heart rhythm and improve coordination of heartbeats. As the condition progresses and structural problems become more clear, surgical procedures may be required.
These include septal myectomy, a procedure that removes a part of the thickened heart muscle to improve blood flow, and mitral valve repair, which focuses on improving how the valve functions and allows smoother blood circulation through the heart. In more advanced stages, when the heart is no longer able to function effectively, a heart transplant may be considered.
Being young and fit does not always guarantee immunity from heart conditions such as cardiomyopathy. Hidden genetic factors, past infections or unexplained causes can silently affect heart health. Paying attention to unusual symptoms and opting for timely medical evaluation can be life-saving, especially in individuals who otherwise consider themselves low-risk.
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