What Is Hypertrophic Cardiomyopathy?

Hypertrophic Cardiomyopathy (HCM) Affects the Heart Muscle

  • Hypertrophic Cardiomyopathy (HCM) is a disease that causes the heart muscle to become abnormally thick, which can make it harder for the heart to pump blood.
  • The disease is often inherited and those with a close family member who had HCM should consider getting genetic testing.
  • In a small number of patients, the thickened heart muscle can lead to life-threatening abnormal heart rhythms (arrhythmias) or even sudden death.
  • Treatment will vary depending on the severity of the disease. Some may just need to make lifestyle adjustments, while others may need medical intervention.

Hypertrophic cardiomyopathy (HCM) is a disease that causes the heart muscle to become abnormally thick, which can make it more difficult for the heart to pump blood. The disease is usually caused by a genetic mutation that is passed down through families.

The disease often doesn’t cause symptoms, and those who have it can carry on normal lives without knowing they have HCM in many cases. However, for a small percentage of people with the disease, the thickened heart muscle can lead to life-threatening abnormal heart rhythms (arrhythmias) or even sudden death.

“With each beat, your heart pumps out blood, but in order to do that, it also has to receive the blood,” Dr. Aeshita Dwivedi, a non-invasive cardiologist at Lenox Hill Hospital tells SurvivorNet. “When the walls of the heart get very thick and abnormal, your heart becomes stiff and becomes less compliant and is not able to accept the blood as it should.”

There are two types of HCM—obstructive (where there is obstruction to the blood flow) and non-obstructive, Dr. Dwivedi explains. What type a person has and how the disease presents will determine which treatment is needed.

Diagnosing Hypertrophic Cardiomyopathy

The disease is normally passed down through family members. If you have a parent with hypertrophic cardiomyopathy, you have a 50% chance of having the genetic mutation for the disease as well. Those with close relatives who were diagnosed should speak to their doctors about the need for screening.

“In some cases, a gene can be identified,” Dr. Dwivedi says. “But in some we’re still learning more about the disease and we don’t exactly understand all the genes that lead to it. If you are lucky that your family has a gene that’s been identified, it can be used to screen your first degree family members like your brother, your sister. If you’re planning to start a family in the future, identifying a gene can be very helpful in risk stratification of your offspring as well, and can also help counsel during pregnancy.”

According to clinical guidelines from the American College of Cardiology and the American Heart Association, in first degree relatives of select patients with genetic or inherited cardiomyopathies, genetic screening and counseling are recommended to detect cardiac disease.

Dr. Philip Weintraub, a cardiology specialist based in New York, explained that diagnosis will depend on the results of several tests.

“To diagnose the disease one must take a thorough history, do a complete physical exam, obtain objective studies, including an electrocardiogram and an echocardiogram, and therefore be able to, through those modalities, put together a working diagnosis,” he explains.

Symptoms of Hypertrophic Cardiomyopathy

Aside from understanding inherited risk, there are some symptoms that may indicate a person has HCM. These include:

  • Chest pain, especially during exercise
  • Fainting, especially during or immediately after exercise
  • Heart murmur (an extra noise heard during heartbeat)
  • Sensation of rapid blood, fluttering or pounding heart beats
  • Shortness of breath, especially during exercise
  • fatigue

Of course, such symptoms as shortness of breath can be properly attributed to many other issues, so it’s important to speak with your doctor and get a diagnosis if you are experiencing any of these symptoms, particularly if HCM runs in your family.

Treating HCM

How HCM is treated depends a lot on the individual patient and the severity of the disease. In some instances, simple lifestyle modifications may be sufficient, while in others, beta blockers (drugs used to manage abnormal heart rhythms) or pacemakers (devices that help the heart to pump blood) may be required.

“In some cases, one can use lifestyle modification in those that are asymptomatic or less than symptomatic. In the more severe cases, one needs to bring in an arsenal of medications,” Dr. Weintraub explains. “In the past, we’ve used beta blockers, [which are] drugs that block adrenaline from the body with the thought process being that if you could decrease contractility of the left ventricle, you will decrease the amount of obstruction that occurs when the blood is being pumped out of the heart.”

Dr. Weintraub also notes that pacemakers have been successful for certain patients. “In planting pacemakers, which reside on the right side of the heart, [those] will force the septum to move with the right side of the heart, so there’s less interference with the contractility and the ejection of the blood from the left ventricle.”

Doctors may also take a combination approach, using multiple techniques to decrease symptoms and increase longevity.

Healthy Living

It’s important for people who have been diagnosed with HCM to communicate with their doctors regularly, Dr. Dwivedi says. Maintaining a healthy lifestyle is also crucial.

“It’s also important that you remain active, which means moderate activity” she says. “A lot of patients with hypertrophic cardiomyopathy are restricted from doing strenuous activity because it can actually make their condition worse, but it’s important to still stay active.”

Dr. Dwivedi recommends healthy habits, such as:

  • Moderate (or supervised) exercise
  • Avoiding excessive alcohol intake
  • Avoiding excessive stress on the body
  • Maintaining a balanced diet

Questions to Ask Your Doctor

  • What kind of symptoms should I be on the lookout for?
  • Is treatment for my HCM needed?
  • What kind of lifestyle modifications do I need?
  • How often will I need to be monitored?

Learn more about SurvivorNet’s rigorous medical review process.

Hypertrophic Cardiomyopathy (HCM) Affects the Heart Muscle

  • Hypertrophic Cardiomyopathy (HCM) is a disease that causes the heart muscle to become abnormally thick, which can make it harder for the heart to pump blood.
  • The disease is often inherited and those with a close family member who had HCM should consider getting genetic testing.
  • In a small number of patients, the thickened heart muscle can lead to life-threatening abnormal heart rhythms (arrhythmias) or even sudden death.
  • Treatment will vary depending on the severity of the disease. Some may just need to make lifestyle adjustments, while others may need medical intervention.

Hypertrophic cardiomyopathy (HCM) is a disease that causes the heart muscle to become abnormally thick, which can make it more difficult for the heart to pump blood. The disease is usually caused by a genetic mutation that is passed down through families.

The disease often doesn’t cause symptoms, and those who have it can carry on normal lives without knowing they have HCM in many cases. However, for a small percentage of people with the disease, the thickened heart muscle can lead to life-threatening abnormal heart rhythms (arrhythmias) or even sudden death.

Read More

“With each beat, your heart pumps out blood, but in order to do that, it also has to receive the blood,” Dr. Aeshita Dwivedi, a non-invasive cardiologist at Lenox Hill Hospital tells SurvivorNet. “When the walls of the heart get very thick and abnormal, your heart becomes stiff and becomes less compliant and is not able to accept the blood as it should.”

There are two types of HCM—obstructive (where there is obstruction to the blood flow) and non-obstructive, Dr. Dwivedi explains. What type a person has and how the disease presents will determine which treatment is needed.

Diagnosing Hypertrophic Cardiomyopathy

The disease is normally passed down through family members. If you have a parent with hypertrophic cardiomyopathy, you have a 50% chance of having the genetic mutation for the disease as well. Those with close relatives who were diagnosed should speak to their doctors about the need for screening.

“In some cases, a gene can be identified,” Dr. Dwivedi says. “But in some we’re still learning more about the disease and we don’t exactly understand all the genes that lead to it. If you are lucky that your family has a gene that’s been identified, it can be used to screen your first degree family members like your brother, your sister. If you’re planning to start a family in the future, identifying a gene can be very helpful in risk stratification of your offspring as well, and can also help counsel during pregnancy.”

According to clinical guidelines from the American College of Cardiology and the American Heart Association, in first degree relatives of select patients with genetic or inherited cardiomyopathies, genetic screening and counseling are recommended to detect cardiac disease.

Dr. Philip Weintraub, a cardiology specialist based in New York, explained that diagnosis will depend on the results of several tests.

“To diagnose the disease one must take a thorough history, do a complete physical exam, obtain objective studies, including an electrocardiogram and an echocardiogram, and therefore be able to, through those modalities, put together a working diagnosis,” he explains.

Symptoms of Hypertrophic Cardiomyopathy

Aside from understanding inherited risk, there are some symptoms that may indicate a person has HCM. These include:

  • Chest pain, especially during exercise
  • Fainting, especially during or immediately after exercise
  • Heart murmur (an extra noise heard during heartbeat)
  • Sensation of rapid blood, fluttering or pounding heart beats
  • Shortness of breath, especially during exercise
  • fatigue

Of course, such symptoms as shortness of breath can be properly attributed to many other issues, so it’s important to speak with your doctor and get a diagnosis if you are experiencing any of these symptoms, particularly if HCM runs in your family.

Treating HCM

How HCM is treated depends a lot on the individual patient and the severity of the disease. In some instances, simple lifestyle modifications may be sufficient, while in others, beta blockers (drugs used to manage abnormal heart rhythms) or pacemakers (devices that help the heart to pump blood) may be required.

“In some cases, one can use lifestyle modification in those that are asymptomatic or less than symptomatic. In the more severe cases, one needs to bring in an arsenal of medications,” Dr. Weintraub explains. “In the past, we’ve used beta blockers, [which are] drugs that block adrenaline from the body with the thought process being that if you could decrease contractility of the left ventricle, you will decrease the amount of obstruction that occurs when the blood is being pumped out of the heart.”

Dr. Weintraub also notes that pacemakers have been successful for certain patients. “In planting pacemakers, which reside on the right side of the heart, [those] will force the septum to move with the right side of the heart, so there’s less interference with the contractility and the ejection of the blood from the left ventricle.”

Doctors may also take a combination approach, using multiple techniques to decrease symptoms and increase longevity.

Healthy Living

It’s important for people who have been diagnosed with HCM to communicate with their doctors regularly, Dr. Dwivedi says. Maintaining a healthy lifestyle is also crucial.

“It’s also important that you remain active, which means moderate activity” she says. “A lot of patients with hypertrophic cardiomyopathy are restricted from doing strenuous activity because it can actually make their condition worse, but it’s important to still stay active.”

Dr. Dwivedi recommends healthy habits, such as:

  • Moderate (or supervised) exercise
  • Avoiding excessive alcohol intake
  • Avoiding excessive stress on the body
  • Maintaining a balanced diet

Questions to Ask Your Doctor

  • What kind of symptoms should I be on the lookout for?
  • Is treatment for my HCM needed?
  • What kind of lifestyle modifications do I need?
  • How often will I need to be monitored?

Learn more about SurvivorNet’s rigorous medical review process.

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