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Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a condition in which the heart muscle becomes thick. The thickening makes it harder for blood to leave the heart, forcing the heart to work harder to pump blood.

HCM is often asymmetrical, meaning one part of the heart is thicker than the other parts. The condition is usually passed down through families (inherited). It is believed to be a result of several problems (defects) with the genes that control heart muscle growth.

Younger people are likely to have a more severe form of hypertrophic cardiomyopathy. However, the condition is seen in people of all ages.

Symptoms:

Symptoms of HCM may include:

  • Chest pain
  • Dizziness
  • Fainting, especially during exercise
  • Heart failure (in some patients)
  • High blood pressure (hypertension)
  • Light-headedness, especially after activity or exercise
  • Sensation of feeling the heart beat (palpitations)
  • Shortness of breath

Other symptoms that may occur include:

  • Fatigue, reduced activity tolerance
  • Shortness of breath when lying down

Some patients have no symptoms. They may not even realize they have the condition until it is found during a routine medical exam.

The first symptom of hypertrophic cardiomyopathy among many young patients is sudden collapse and possible death. This is caused by very abnormal heart rhythms (arrhythmias). HCM is a major cause of death in young athletes who seem completely healthy but die during heavy exercise.

If you experience any symptoms of HCM contact your medical provider immediately.

Treatment:

The goal of treatment is to control symptoms and prevent complications. Some patients may need to stay in the hospital until the condition is under control (stabilized).

If you have symptoms, you may need medication to help the heart contract and relax correctly. Drugs may include beta-blockers and calcium channel blockers. These medicines reduce chest pain and pain during exercise. Medications will often relieve symptoms so patients do not need more invasive treatments.

Some people with arrhythmias may need anti-arrhythmic medications. If the arrhythmia is due to atrial fibrillation, blood thinners may also be used to reduce the risk of blood clots.

Some patients may have a permanent pacemaker placed. However, pacemakers are used less often today than they were in the past.

When blood flow out of the heart is severely blocked, an operation called surgical myectomy may be performed. This procedure cuts and removes the thickened part of the heart. Patients who have this procedure often show significant improvement. If the heart's mitral valve is leaking, surgery may be done to repair or replace the valve.

In some cases, patients may be given an injection of alcohol into the arteries that feed the thickened part of the heart (alcohol septal ablation).

An implantable-cardioverter defibrillator (ICD) may be needed to prevent sudden death. ICDs are usually used in high-risk patients. High risks include:

  • Drop in blood pressure during exercise
  • Family history of cardiac arrest
  • History of cardiac arrest or ventricular tachycardia
  • Life-threatening heart rhythms on a Holter monitor
  • Severe heart muscle thickness

Texas Health is committed to providing quality care to heart and vascular patients throughout North Texas and beyond. While various technologies and services are discussed here, not all of our hospitals offer every treatment and diagnostic technology highlighted. Call 1-877-THR-WELL to learn more about heart and vascular services at a Texas Health hospital near you.