What is Hypertrophic Cardiomyopathy?

Hypertrophic cardiomyopathy (HCM) is an enlargement and thickening of the heart muscle which can block the flow of blood, causing the heart to pump harder. For most people, there are few if any symptoms and they live a normal life. Other people can develop symptoms and potentially severe complications. Hypertrophic cardiomyopathy affects about 1 in 500 Americans. It occurs in persons of all ages and both sexes. 

Signs and Symptoms of Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy doesn’t usually have a negative impact on health. It has, however, been linked to serious medical conditions on occasion:

• Atrial fibrillation: Thickened heart muscles can alter the heart’s electrical function, leading to arrhythmias. 
• Obstructed blood flow: Some persons with this condition experience a reduction in the volume of oxygenated blood exiting the heart. 
• Mitral valve problems: Hypertrophic cardiomyopathy is sometimes associated with damaged or improperly functioning heart valves. 
• Dilated cardiomyopathy: Some longtime patients experience decreases in the heart’s ability to effectively pump blood. 
• Heart failure: Thickened or stiffened muscles can hamper the heart’s primary function of serving as the body’s circulatory motor. 
• Sudden cardiac death: In rare cases, hypertrophic cardiomyopathy can cause cardiac arrest and sudden death. 

Hypertrophic cardiomyopathy symptoms can include:

• Breathlessness with exertion (or sometimes at rest)
• Chest pain
• Dizziness, lightheadedness and fainting especially after exercise
• A sensation of rapid, pounding or fluttering heartbeat
• Heart failure

Hypertrophic Cardiomyopathy Diagnosis

If hypertrophic cardiomyopathy is suspected, we perform a physical examination and ask questions about symptoms. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Common procedures for hypertrophic cardiomyopathy diagnosis can include:

Cardiac catheterization: A long, thin flexible tube is threaded through a blood vessel in the arm or groin and to the heart. Contrast material is injected through the tube and a type of X-ray video is taken to show how the heart functions and to look for heart blockages.

Magnetic resonance imaging (MRI): A large magnet, radio waves and a computer are used to produce pictures of the heart and blood vessels.

Echocardiogram: This ultrasound exam uses soundwaves to take moving pictures of the heart’s chambers and valves.

Electrocardiogram (EKG): This test measures the electrical activity of the heart and can help determine if parts of the heart are enlarged, overworked or damaged. The heart’s electrical currents are detected by 12 to 15 electrodes that are attached to the arms, legs and chest via sticky tape.

Genetic testing or screening: Some types of cardiomyopathy run in families. A genetic test can identify the condition in other family members, determine the chances of a parent passing the gene to a child and identify hereditary cardiomyopathy before symptoms appear.

Holter monitor: This portable EKG device continuously records the heart’s rhythms and is worn for 24 to 48 hours during normal activity.

Stress testing: This test is conducted during exercise. If a person can't exercise, medicine is given to increase heart rate. Used along with an EKG, the test can show changes to the heart’s rate, rhythm or electrical activity as well as blood pressure. Exercise makes the heart work hard and beat fast while heart tests are administered.

Hypertrophic Cardiomyopathy Causes

Scientists believe that there is a strong genetic factor in developing hypertrophic cardiomyopathy, meaning that it can be inherited from your parents. In other cases, you may acquire this condition later in life, due in part to exposure to certain environmental factors, possibly including another disease. The causes of hypertrophic cardiomyopathy, especially in children, aren’t fully understood.

Hypertrophic Cardiomyopathy Risk Factors

Risk factors that could contribute to hypertrophic cardiomyopathy include:

Genetics: If a parent has hypertrophic cardiomyopathy, a child has a 50 percent chance of developing the condition.

Growth: HCM commonly develops in association with growth and is usually apparent by the late teens or early twenties, although the condition can affect people of any age.

Hypertrophic Cardiomyopathy Prevention

While you cannot prevent inherited types of hypertrophic cardiomyopathy, you can help prevent hypertrophic cardiomyopathy in these ways:

Control high blood pressure and cholesterol: Stop smoking, eat a healthy diet, exercise and take medications as prescribed.

Get regular checkups: If you experience new or changing symptoms, see your physician immediately.

Take your medications as prescribed: If you’ve been prescribed a medication for hypertrophic cardiomyopathy or high blood pressure, be sure to take it as prescribed.

Hypertrophic Cardiomyopathy Prognosis

Hypertrophic cardiomyopathy prognosis depends upon the individual’s condition. Most people with HCM have mild or no symptoms and lead normal, active lives. Some patients experience more severe, progressive symptoms that require medications and/or treatment procedures. A minority of patients have an increased risk of sudden death, often at a young age, and often during vigorous sports activity. 

Hypertrophic Cardiomyopathy Treatment and Recovery

Hypertrophic Cardiomyopathy treatments include:

Lifestyle Changes

A healthy diet including a variety of fruits, vegetables, and grains and regular physical activity are part of a healthy lifestyle. Quitting smoking, losing excess weight, reducing stress and treating underlying conditions such as diabetes and high blood pressure may help manage a condition that's contributing to HCM. 

Medications

Your physician may prescribe medications to control blood pressure, slow heart rate and keep the heart beating with a normal rhythm.

Hypertrophic Cardiomyopathy Surgery Options

There are several types of procedures that may be used to treat hypertrophic cardiomyopathy, including:

• Implantable cardioverter defibrillator (ICD): An ICD is inserted under the skin, just below the collarbone, with thin wires leading to the heart. It monitors heart rhythm and delivers electric shocks, when needed, to control abnormal heart rhythms. 
• Septal ablation: During this procedure, a small portion of the thickened heart muscle is destroyed by injecting alcohol through a long, thin catheter into the artery supplying blood to that area. The procedure reduces symptoms and decreases complications associated with HCM. 
• Septal myectomy: In this procedure, a surgeon removes part of the thickened heart muscle wall (septum) that separates the two ventricles. Removing this improves blood flow through the heart and reduces mitral valve regurgitation.

Hypertrophic Cardiomyopathy Complications

Hypertrophic Cardiomyopathy complications may include:

Blood clots: If the heart cannot pump effectively, blood clots may form in the heart and enter the bloodstream where they can block blood flow to other organs.

Cardiac arrest and sudden death: Hypertrophic cardiomyopathy can lead to arrhythmias that could result in fainting or even cardiac arrest if the heart stops beating.

Heart failure: Hypertrophic cardiomyopathy can weaken the heart and cause it to be unable to pump oxygen-rich blood to the rest of the body efficiently.

Valve problems: If the heart is enlarged, valves may not close properly, affecting how the blood flows through the heart and to the rest of the body.

Sudden cardiac death: Although rare, people with HCM are at increased risk of premature death, which can occur with little or no warning at any age.