Hypertrophic Cardiomyopathy

What Is Hypertrophic
Cardiomyopathy?
Hypertrophic cardiomyopathy (HCM) is a
condition in which your heart muscle, or
myocardium, becomes thicker than
normal. This interferes with your heart’s
ability to pump blood.
In most cases, HCM doesn’t cause any
symptoms. People with HCM are
generally able to lead normal lives.
However, some cases can become
serious. Serious cases may develop either
slowly or suddenly.
HCM occurs in about one in every 500
people in the United States.

Recognizing the Symptoms of HCM

Many people with HCM don’t experience
any symptoms. However, the following
symptoms may occur during physical
activity:
 chest pain
 shortness of breath
 fainting
 dizziness
Other symptoms that might occur, at any
time, include:
 fatigue
 shortness of breath
 heart palpitations, which are pounding
or fluttering heartbeats
 high blood pressure

What Causes HCM?

Genetics
HCM is typically an inherited condition.
Defective genes can cause your heart
muscle to thicken. You have a 50
percent chance of inheriting one of these
genes if one of your parents is affected by
HCM.
Inheriting the gene doesn’t necessarily
mean that you’ll have symptomatic
disease. HCM follows a dominant pattern
of inheritance. However, symptoms don’t
always develop in people with the
defective gene.

Other Causes
Other possible causes of HCM include
aging and high blood pressure. In some
cases, the cause of HCM is never
identified.

How Is HCM Diagnosed?

Different tests can be used to diagnose
HCM.

Physical Exam
Your doctor will listen for a heart murmur
or unusual heartbeats. Heart murmurs
may occur if thickened heart muscle
disrupts blood flow to your heart.

Echocardiogram
This is the most common diagnostic test
for HCM. An echocardiogram creates
images of your heart using sound waves.
Your doctor will look for any unusual
movements.

Electrocardiogram
An electrocardiogram is used to measure
the electrical activity in your heart. HCM
can cause abnormal results.

Holter Monitor
A Holter monitor is a portable
electrocardiogram that you can wear
throughout the day. Your doctor will have
you wear it for 24 to 48 hours. This allows
your doctor to see how your heartbeat
changes during different activities.

Cardiac MRI
A cardiac MRI uses a magnetic field to
produce detailed images of your heart.

Cardiac Catheterization
This test is used to measure the pressure
of blood flow in your heart and look for
blockages. To perform this test, your
doctor will place a catheter in one of your
arteries in your arm or near your groin.
The catheter is carefully threaded up
through your arteries to your heart. Once
it reaches your heart, dye is injected so
your doctor can take detailed X-ray
images.

How Is HCM Treated?

Treatment for HCM focuses on relieving
symptoms and preventing complications,
especially sudden cardiac death. The
methods used depend on your:
 symptoms
 age
 activity level
 heart function

Medications
Beta-blockers and calcium channel
blockers relax your heart muscle.
Relaxation helps it work better.
If you have an irregular heart rhythm, your
doctor might prescribe antiarrhythmic
medications, such as amiodarone.
You might need to take antibiotics before
dental procedures or surgery to lower your
risk of infective endocarditis.

Septal Myectomy
A septal myectomy is an open-heart
surgery that’s done to remove part of your
thickened septum. The septum is the
heart muscle wall between your two lower
heart chambers, which are your ventricles.
It helps improve blood flow through your
heart.
A septal myectomy is done only if
medications don’t reduce your symptoms.

Septal Ablation
Septal ablation involves the use of alcohol
to destroy part of your thickened heart
muscle. The alcohol is injected through a
catheter placed in the artery that supplies
the part of your heart that’s being treated.
A septal ablation is often done in people
who can’t have a septal myectomy.

Pacemaker Implantation
If you have an irregular heart rate and
rhythm, a tiny electronic device called a
pacemaker can be placed under the skin
on your chest. The pacemaker helps
regulate your heart rate by sending
electrical signals to your heart.
This procedure is less invasive than septal
myectomies and ablations. It’s also
usually less effective.

Implantable Cardioverter Defibrillator

(ICD)
An implantable cardioverter defibrillator
(ICD) is a small device that uses electric
shocks to track your heartbeat and fix
dangerous, abnormal heart rhythms. It’s
placed inside your chest.
ICD is often used in people who have a
high risk of sudden cardiac death.

Lifestyle Changes
If you have HCM, your doctor may
recommend lifestyle changes to reduce
your risk of complications. This includes:
 eating a healthy diet
  keeping your weight at a healthy level
 doing low-intensity physical activities
 limiting alcohol intake, since alcohol
can cause abnormal heart rhythms

Potential Long-Term Complications of

HCM
Many people with HCM will never have
any serious health problems caused by it.
However, HCM can cause severe
complications in some people. The most
common complications of HCM are:

Sudden Cardiac Arrest

Sudden cardiac arrest occurs when your
heart suddenly stops working. This
condition is also called “sudden cardiac
death.” This is typically caused by a rapid
heart rhythm known as ventricular
tachycardia. Without emergency
treatment, sudden cardiac arrest can be
fatal. HCM is the leading cause of sudden
cardiac death in people who are under 30.
You might be at higher risk for sudden
cardiac death if you have one or more of
the following:
 a family history of sudden cardiac
death
 poor heart function
 severe symptoms
 a history of irregular heart rhythms with
a fast heart rate
 a history of fainting on several
occasions and you’re young
 an unusual blood pressure response to
physical activity

Heart Failure
When your heart doesn’t pump the
amount of blood that your body needs,
you’re experiencing heart failure.

Dilated Cardiomyopathy
This diagnosis means your heart muscle
has become weak and enlarged. The
enlargement makes your heart work less
effectively.

Infective Endocarditis
When the inner lining of your heart or your
heart valves become infected, it’s known
as infective endocarditis. This can happen
when bacteria or fungi enter your
bloodstream and get into your heart.
Infective endocarditis can cause tissue
scarring, holes, or growths in your heart
valves. It can be fatal without treatment.

Coping and Getting Support

Having a disease like severe HCM can
raise your risk of emotional problems.
Some people have trouble coping with the
adjustments they have to make, such as
restricting exercise and relying on
medication for the rest of their lives.
If you’re having difficulty coping with HCM,
your doctor might recommend seeing a
therapist or joining a support group. You
might also benefit from medications used
to treat anxiety or depression.