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Cardiomyopathies in adolescents: dilated, hypertrophic, and restrictive
1Department of Pediatrics, University of Utah School of Medicine, Heart Transplant Program, Primary Children's Medical Center, 100 North Medical Drive, Salt Lake City, Utah 84113, USA.
Insights
Dilated, hypertrophic, and restrictive cardiomyopathies in adolescents often have unknown causes. While treatments aim to improve symptoms and survival, heart transplantation is an option for severe cases.
Area of Science:
- Cardiology
- Pediatric Cardiology
Background:
- Adolescents are affected by three primary cardiomyopathy types: dilated, hypertrophic, and restrictive.
- The etiologies for most pediatric cardiomyopathies remain largely unknown.
- Current treatments focus on symptom management, survival, and hemodynamic support.
Purpose of the Study:
- To summarize current understanding and treatment approaches for adolescent cardiomyopathies.
- To highlight the need for further research into the causes of these conditions.
- To discuss the role of heart transplantation in managing refractory cases.
Main Methods:
- Review of existing literature on pediatric cardiomyopathies.
- Analysis of current treatment strategies extrapolated from adult studies.
- Discussion of ongoing pediatric clinical trials.
Main Results:
- Cardiomyopathies present with variable symptoms, including sudden death risk.
- Medical management is the primary approach, often adapted from adult protocols.
- Heart transplantation offers good intermediate-term success for eligible patients.
Conclusions:
- Adolescent cardiomyopathies require further etiological research.
- Standardized pediatric treatment protocols are evolving.
- Heart transplantation remains a vital option for end-stage pediatric heart disease.
Abstract:
Three major types of cardiomyopathies affect adolescents: dilated, hypertrophic, and restrictive. At the present time the etiologies of the majority of these cardiomyopathies in children remain elusive. Treatment of these diseases is generally directed toward improving symptoms, survival, myocardial performance, and hemodynamics. Most treatment strategies are extrapolated from studies in adults with these types of cardiomyopathies, although prospective, randomized therapeutic trials are currently underway in children. All three types of cardiomyopathy can be associated with a wide range of symptoms (from none to severe) and also are associated with sudden death. For those in whom medical management fails, heart transplantation is a therapeutic option with an excellent intermediate-term success rate.