HYPERTROPHIC CARDIOMYOPATHY

 Basic information

description

Hypertrophic cardiomyopathy (HCM) is a chronic heart condition that produces an enlarged heart muscle. It can obstruct the blood flow from the heart (obstructive cardiomyopathy) and cause symptoms. If blood flow is normal (nonobstructive cardiomyopathy), this condition can go undetected for years. HCM affects all ages, but is more common in young adults.

FREQUENT SIGNS & SYMPTOMS

• Many patients have no symptoms. Symptoms that occur are often felt after exercising or exertion.
• Chest pain (called angina pectoris).
• Heart palpitations or fluttering.
• Faintness.
• Shortness of breath (may awaken person from sleep).
• Fatigue.
• Dizziness or lightheadedness.

causes

Thickening of the heart muscle (myocardium). This is caused by a defect in the genes and often runs in families. The thickened walls obstruct the flow of blood, and the heart may be unable to pump enough blood for the needs of the body.

risk increases with

Family history of HCM. It is the most common inherited heart defect.

PREVENTIVE MEASURES

It can not be prevented. If you have a family history of HCM, ask your doctor about genetic counseling before starting a family.

expected outcomes

Symptoms can be controlled with treatment and lifestyle changes. Lifelong medical follow-up is needed. The main goal is prevention of sudden death.

possible complications

• Abnormal heart rhythm.
• Heart failure.
• Mitral valve problems.
• Sudden death.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and listen to your heart with a stethoscope. Questions will be asked about your symptoms and family medical history. Medical tests include an echocardiogram and ECG (electrocardiogram) to check the structure and function of the heart. Other heart tests will be done as needed.
• Treatment can include drugs, lifestyle changes, pacemaker or defibrillator insertion, or surgery.
• Lifestyle changes involve reducing activity levels.
• An electronic cardiac pacemaker may be inserted. It helps relieve symptoms by changing the pattern of the heartbeat.
• An implantable-cardioverter defibrillator may be inserted. It can help prevent sudden death.
• A procedure that uses alcohol injected into an artery may be recommended. It can help to reduce obstruction and improve symptoms.
• Surgery may be recommended to reduce the obstruction, if other treatments do not control the problem.
• Counseling may be helpful in adjusting to emotional effects of chronic illness.
• Wear a medical alert type bracelet or pendant to indicate you have this disorder.
• Screening tests for HCM should be performed for close relatives of a patient diagnosed with the disorder.
• Family members should learn CPR (cardiopulmonary resuscitation) in case there is a patient emergency.

medications

Beta-adrenergic blockers or calcium-channel blockers to prevent heartbeat irregularities will be prescribed for most patients.

activity

• Instructions will be provided about how much physical activity is ideal. Your ability to increase activity is dependent on your response to therapy. Don't regard yourself as an invalid.
• Avoid strenuous activities and sports because of the high risk of sudden death.

diet

Usually no special diet. A low-salt diet or reduced fluid intake may be recommended if you have fluid build-up. This is a possible sign of congestive heart failure.

 notify our office if

• You or a family member has symptoms of hypertrophic cardiomyopathy.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
• Family members need to schedule screening tests.

Special Notes: