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
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
Younger people are likely to have a more severe form of
hypertrophic cardiomyopathy. However, the condition is seen in
people of all ages.
Symptoms of HCM may include:
- Chest pain
- 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
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
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
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
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.