In this condition, the heart muscle thickens, which makes it harder for the heart to pump blood. Learn about the causes and treatment.
Hypertrophic cardiomyopathy (HCM) is a disease in which the heart muscle becomes thickened, also called hypertrophied. The thickened heart muscle can make it harder for the heart to pump blood.
Many people with hypertrophic cardiomyopathy don't realize they have it. That's because they have few, if any, symptoms. But in a small number of people with HCM, the thickened heart muscle can cause serious symptoms. These include shortness of breath and chest pain. Some people with HCM have changes in the heart's electrical system. These changes can result in life-threatening irregular heartbeats or sudden death.
In hypertrophic cardiomyopathy, the muscular heart wall called the septum often becomes thicker than usual. But the thickening can happen anywhere in the left lower heart chamber, also called the left ventricle.
Symptoms of hypertrophic cardiomyopathy can include one or more of the following:
Many conditions can cause shortness of breath and fast, pounding heartbeats. It's important to get a prompt checkup to find the cause and receive the right care. See your healthcare professional if you have a family history of HCM or any symptoms related to hypertrophic cardiomyopathy.
Call 911 or your local emergency number if you have any of the following symptoms for more than a few minutes:
Hypertrophic cardiomyopathy usually is caused by changes in genes that cause the heart muscle to thicken.
Hypertrophic cardiomyopathy typically affects the wall between the two bottom chambers of the heart. This wall is called the septum. The chambers are called the ventricles. The thickened wall might block blood flow out of the heart. This is called obstructive hypertrophic cardiomyopathy.
If there's no significant blocking of blood flow, the condition is called nonobstructive hypertrophic cardiomyopathy. But the heart's main pumping chamber, called the left ventricle, might stiffen. This makes it hard for the heart to relax. The stiffness also lessens the amount of blood the ventricle can hold and send to the body with each heartbeat.
Heart muscle cells also become arranged differently in people with hypertrophic cardiomyopathy. This is called myofiber disarray. It can trigger irregular heartbeats in some people.
Hypertrophic cardiomyopathy usually is passed down through families. That means it's inherited. People with one parent with hypertrophic cardiomyopathy have a 50% chance of having the gene change that causes the disease.
Parents, children, or brothers or sisters of a person with hypertrophic cardiomyopathy should ask their healthcare team about screening tests for the disease.
Complications of hypertrophic cardiomyopathy can include:
There is no known way to prevent hypertrophic cardiomyopathy (HCM). It's important to find the condition with tests as early as possible to guide treatment and prevent complications.
Hypertrophic cardiomyopathy usually is passed down in families. If you have a parent, brother, sister or child with hypertrophic cardiomyopathy, ask your healthcare team if genetic screening is right for you. But not everyone with HCM has a gene change that tests can detect. Also, some insurance companies may not cover genetic testing.
If genetic testing isn't done, or if the results aren't helpful, screening may be done with repeated echocardiograms. Echocardiograms use sound waves to make pictures of the heart.
For people who have a family member with hypertrophic cardiomyopathy:
You may need to have an echocardiogram more often based on your overall health and healthcare team's preference.
A healthcare professional examines you and listens to your heart with a device called a stethoscope. A heart murmur may be heard while listening to the heart.
A member of your healthcare team usually asks questions about your symptoms and your medical and family history. Genetic testing or counseling may be recommended if you have a family history of the condition.
Tests are done to check the heart and look for causes of any symptoms.
The goals of hypertrophic cardiomyopathy treatment are to ease symptoms and prevent sudden cardiac death in people at high risk. Treatment depends on how severe the symptoms are.
If you have cardiomyopathy and are pregnant or thinking about pregnancy, talk with your healthcare professional. You might be referred to a doctor with experience in high-risk pregnancies. This doctor might be a perinatologist or a maternal-fetal medicine specialist.
Medicines can help reduce how strongly the heart muscle squeezes and slow the heart rate. That way, the heart can pump blood better. Medicines to treat hypertrophic cardiomyopathy and its symptoms might include:
Several surgeries or procedures are available to treat cardiomyopathy or its symptoms. They include:
Septal myectomy. This open-heart surgery might be recommended if medicines don't improve symptoms. It involves removing part of the thickened, overgrown wall between the heart chambers. This wall is called the septum. Septal myectomy helps improve blood flow out of the heart. It also reduces backward flow of blood through the mitral valve.
The surgery can be done using different approaches, depending on the location of the thickened heart muscle. In one type, called apical myectomy, surgeons remove thickened heart muscle from near the tip of the heart. Sometimes the mitral valve is repaired at the same time.
A septal myectomy is an open-heart surgery. A surgeon removes part of the thickened, overgrown septum between the lower heart chambers called the ventricles, as shown in the heart on the right.
Lifestyle changes can lower the risk of complications related to hypertrophic cardiomyopathy. Try these healthy habits:
Connect with friends and family or a support group. You may find that talking about hypertrophic cardiomyopathy with others in similar situations can help.
It also is important to control emotional stress. Getting more exercise and practicing mindfulness are ways to ease stress. If you have anxiety or depression, talk to your healthcare team about strategies to help.
You may be referred to a doctor trained in heart diseases. This type of care professional is called a cardiologist. Here's some information to help you prepare for your appointment.
When you make the appointment, ask if you need to follow any restrictions before the checkup. For instance, you may need to change your activity level or your diet. Make a list of:
Questions to ask your healthcare professional might include:
Feel free to ask other questions you have.
Your healthcare professional is likely to ask you questions such as:
Before your appointment, ask your family members if any relatives have been diagnosed with hypertrophic cardiomyopathy or have had unexplained, sudden death.
If exercise makes your symptoms worse, don't do strenuous exercise until you have seen your healthcare professional. Ask for specific exercise recommendations.