What are the 4 Stages of Cardiomyopathy?

The 4 Stages of Cardiomyopathy

Cardiomyopathy refers to a group of diseases affecting the heart muscle (myocardium). It can lead to several other conditions, including arrhythmia, cardiac arrest and, ultimately, heart failure. However, heart failure does not occur suddenly. There are four stages to it. Let us discuss them below.

Stages of Heart Failure

There are 4 stages to heart failure, starting from being at risk and ending in advanced heart failure. They are as follows:

1. Stage A: At Risk of Heart Failure

In stage A, people are at a major risk of developing heart failure. There is no functional or structural damage to your heart. People do not show symptoms. Apart from cardiomyopathy, several other diseases also increase the risk of this disease. They are:

• Family history of cardiomyopathy
• High blood pressure
• Coronary heart disease
• Increased exposure to cardiotoxic agents
• Obesity
• Diabetes
• Genetic variant of cardiomyopathy

Treatment for Stage A Heart Failure

Doctors recommend several lifestyle changes for people in stage A, including:

• No alcohol
• No tobacco products
• Exercising every day
• Eating a balanced diet

Doctors can also treat the underlying conditions causing heart disease. For example, medicines like angiotensin-converting enzyme inhibitors (ACE-I) treat coronary artery disease.

2. Stage B: Pre-Heart Failure

At this stage, people are still unaware of any symptoms. However, they develop structural changes in the functioning of the heart. The left ventricle does not work well, and structural abnormalities will show up in an echocardiogram.

Treatment for Stage B Heart Failure

If you are diagnosed with stage B HF, your doctor will first prescribe treatments for stage A. After that, they may prescribe medications or surgery based on the damage. Medications can include:

• Aldosterone antagonist
• Angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB)
• Beta-blocker

3. Stage C: Symptomatic Heart Failure

People start to show symptoms of heart failure at this stage. The heart’s pumping ability is compromised. Symptoms include the following:

• Fatigue
• Swelling in the feet and legs
• Coughing
• Shortness of breath

It is an advanced stage, and most people are diagnosed at this stage.

Treatment for Stage C Heart Failure

Along with treatments for stages A and B, your cardiologist may suggest the following:

• Sodium-glucose transport-2 inhibitors (SGLT2i)
• Water pill (diuretic)
• Hydralazine/nitrate combination
• Biventricular pacemaker
• Sodium restriction
• Medicines that slow your heart rate
• Implantable cardiac defibrillator (ICD)

These treatments will help you manage the symptoms and possibly stop progression to stage D.

4. Stage D: Advanced Heart Failure

It is the most advanced stage of heart failure, where patients need to be hospitalised. Symptoms can disrupt daily life and can even cause severe discomfort at rest. Even with previous treatments, symptoms may be visible. Stage D HF symptoms are as follows:

• Breathlessness while sitting
• Fluid buildup in your body (oedema) causes swelling.
• Irregular heartbeat
• Loss of appetite

Treatment for Stage D Heart Failure

Based on how severe the symptoms are, doctors will prescribe the following:

• Ventricular assist devices
• Heart transplant
• Continuous infusion of inotropic drugs
• Heart surgery
• Hospice care

Apart from these, managing other associated diseases is very important. Always reach out to your doctor if you face new or worsening symptoms.

Living with cardiomyopathy can be difficult, but lifestyle changes and regular check-ups can relieve symptoms. With proper care, you can improve your quality of life.

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