A recent study suggested that depression and anxiety are common among those with hyptertrophic cardiomyopathy, and undertreated among such people. Of 148 patients screened for mental health problems, 37 percent of the patients fulfilled criteria for anxiety disorder, and 21 percent for a mood disorder. Presence of mood disorders were typically associated with chest pain, poor social adjustment, and higher perceived risk of death, as well as problems with sexual relations. The same was true of those with anxiety disorders, with the exception of an absence of sexual problems, and those with anxiety tended to see their physical symptoms as severe. Cardiomyopathy may manifest itself as an autoimmune disorder, leading to the possibility of a distinct subset of the disease to be distinguished from its idiopathic variety:
“During the last 10 years there have been many investigations showing distinct autoantibodies or other immune factors in heterogeneous subsets of DCM which have contributed supportive and confounding evidence to the hypothesis that multiple autoimmune mechanisms are involved in DCM. Accumulated evidence hitherto demonstrated a variety of circulating autoantibodies in the sera of patients with DCM including antireceptor autoantibodies, myosin and ADP/ATP translocator protein, etc. Data available from both in-vitro and in-vivo studies of anti-receptor autoantibodies as well as from other autoantibodies and autoreactive lymphocytes demonstrated clearly that a subgroup of DCM is autoimmunity-mediated. This is understandable because DCM is heterogeneous, implying that different subgroups of DCM may have different pathogeneses. It may be practical in the future to separate “autoimmune cardiomyopathy” from other “idiopathic” DCM.”
