Randy Travis case highlights cardiomyopathy

The cause isn't always easy to pin down and treatment isn't always effective

By now, you've probably heard about Randy Travis' condition. The 54-year-old country singer was admitted to a hospital for an illness called viral cardiomyopathy, which happens when a virus attacks the heart muscle and causes the heart to become enlarged and weakened.

Oftentimes the condition, which can lead to heart failure, is associated with things like high blood pressure and diabetes rather than a virus, medical authorities say.

"The most common cause of cardiomyopathy is coronary artery disease, but this can also be caused by things like hypertension, valvular heart disease, alcohol abuse, thyroid disease and numerous other causes" said Dr. Martha Gulati, a cardiologist at the Ohio State University Wexner Medical Center, in an interview with ConsumerAffairs. Gulati is not involved in Travis' treatment procedures.

If these other causes aren't found and if the patient recalls having an infection or fever preceding the onset of symptoms, "we usually then presume it is a viral cardiomyopathy. This is an infection of the heart, which ultimately weakens the heart."  

Viral cause

The flu can cause viral cardiomyopathy but the most common virus is  adenovirus, Gulati said. 

"Usually once it has affected the heart, symptoms will be shortness of breath, leg swelling and often have palpitations and fever and even chest pain. Some patients present with sudden cardiac death and then this diagnosis is made," she said.

Dr. Randall Starling, of the cardiovascular medicine department at the Cleveland Clinic, said although viral cardiomyopathy is fairly common, it can sometimes be hard to diagnose.

Additionally, Starling says that many times viral cardiomyopathy is given as a broad diagnosis if doctors aren't able to determine what's causing the size of the heart to increase.  

"Even if we took a biopsy of the heart or cultured it, we rarely make a 100% certain diagnosis that a virus caused it," said Starling in an interview with CBS News.

"In our world, this is one of the more common things we deal with. For the patient and the family, it's devastating, but it's a common scenario we deal with on a daily basis."

Experts say other symptoms of viral cardiomyopathy include parts of the body not getting enough blood and the lungs becoming filled with fluid. 

If the heart doesn't begin to function properly, long-lasting therapy and treatment will be needed. The odds?

"[It's] really hard to say at this point," she says. "It depends on whether his heart function recovers. But about 58% of people do recover spontaneously so this is encouraging."

The Travis case

As for Travis, doctors have yet to say whether his condition was caused by a virus something else. 

"Based on reports, which don't say much, we don't know if this is just viral or if alcohol could contribute in some way to his heart failure," said Gulati. "That is really the unknown part of this.

"Second, there is really no direct therapy for viral myocarditis aside from supportive care with medications we use for any cause of heart failure. Sometimes patients who don't recover from this will need a left ventricular assist device implanted into them or even need a heart transplant."

According to the Centers for Disease Control and Prevention, heart failure is the main cause of over 55,000 deaths each year in the United States. Currently, there are 5.7 million people in the U.S. living with the disorder.

Story provided by ConsumerAffairs.
Consumer Affairs

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