Cardiomyopathy is a term that encompasses several types of heart disease. But one type, hypertrophic cardiomyopathy (HCM), occurs in about one of every 500 people and is the most common cause of sudden death in those under age thirty. With HCM, the heart muscle becomes thick and stiff. This causes the heart’s performance to be impeded and the proper flow of blood to the body is prevented.
Hypertrophic cardiomyopathy can occur at any age and in men and women. HCM can have serious consequences for some including chest pain, shortness of breath, irregular heart rhythm and even sudden death. Others with the condition can lead very normal lives with few or no complications.
How it works
When the heart muscle becomes thick, it is said to be “hypertrophied.” The swollen heart muscle cells cause the walls of the ventricles to swell. The ventricle itself may remain the same size but the wall within it swells. Known as obstructive hypertrophic cardiomyopathy, this happens more often to the left ventricle, which supplies blood to the body through the aorta. The right ventricle supports the lungs with blood flow through the pulmonary artery.
By contrast, in non-obstructive hypertrophic cardiomyopathy, blood flow through the left ventricle may not be obstructed. The right ventricle could be affected or the thickening could occur at the bottom of the heart.
Causes and Symptoms
According to the American Heart Association (AHA), the cause of hypertrophic cardiomyopathy is unknown. But it is believed that HCM is often inherited from one generation to the next. High blood pressure, aging and diseases such as diabetes and thyroid conditions may also increase the possibility of HCM.
In addition to chest pain, shortness of breath, and irregular heart rhythm or palpitations, other symptoms of HCM are fatigue and fainting. When young people, including young athletes, succumb to cardiac arrest, hypertrophic cardiomyopathy is often cited as the cause.
If the symptoms are mild, they may go unnoticed and result in the patient having little or no discomfort.
HCM can be diagnosed in several ways. A regular physical exam may reveal the symptoms, such as irregular heartbeats, even though the patient may not be aware that they exist. Another method of diagnosis may include a painless electrocardiogram (EKG or ECG). This measures electrical activity in the heart and can detect how long it takes an electrical wave to travel through the heart. If a part of the heart is enlarged or thickened, as in the case of HCM, it can be detected.
Chest x-rays, blood tests, stress tests, computed tomography (CT scan) or magnetic resonance imaging (MRI) can also be used in diagnosing HCM.
Treatment of hypertrophic cardiomyopathy can help control the symptoms and help those diagnosed with it live life to their expectations. It can keep the symptoms from worsening and help reduce the risk of cardiac arrest.
Lifestyle changes, such as a proper diet and exercise schedule, are often prescribed. Maintaining the right weight, reducing stress and eliminating habits such as smoking or overindulgence in alcohol help control HCM symptoms and improve the entire cardiovascular system.
Medicines that control blood pressure, lower the heart rate, balance electrolytes and prevent blood clots may be prescribed by a cardiologist. Other medication that reduce inflammation and remove excess fluid may also be prescribed.
If medicine and lifestyle changes don’t alleviate HCM symptoms, several surgical procedures can be considered. A septal myectomy removes part of the thickened septum between the ventricles to improve blood flow.
In the procedure known as septal ablation, a catheter is used to insert alcohol into the artery. That removes some of the thickness that creates the blood flow impediment.
Another surgical remedy includes inserting an implantable cardioverter-defibrillator (ICD) that restores the heartbeat to a normal rhythm if an irregular heartbeat occurs. This would be recommended if life-threatening arrhythmia is found and it is determined that it could result in sudden death.
To learn more about hypertrophic cardiomyopathy and treatment options, log on to vascularhealthclinics.org.