CausesHypertrophic cardiomyopathy 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
* Chest pain
* Dizziness
* Fainting, especially during exercise
* Heart failure (in some patients)
* High blood pressure (hypertension)
* Light-headedness, especially with or after activity or exercise
* Sensation of feeling the heart beat (palpitations)
* Shortness of breath
Other symptoms that may occur are:
* FatigueFatigue, 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 (arrhythmiasarrhythmias), or from the blockage of blood leaving the heart to the rest of the body.
Hypertrophic cardiomyopathy is a major cause of death in young athletes who seem completely healthy but die during heavy exercise. However, certain normal changes in athletes' hearts can confuse the diagnosis.
Exams and Tests
Exams and Tests
The health care provider will perform a physical exam and listen to the heart and lungs with a stethoscope. Listening with a stethoscope may reveal abnormal heart soundsabnormal heart sounds or a murmur. These sounds may change with different body positions.
The pulse in your arms and neck will also be checked. The doctor may feel an abnormal heartbeat in the chest.
Tests used to diagnose heart muscle thickness, problems with blood flow, or leaky heart valves (mitral valve regurgitationmitral valve regurgitation) may include:
* 24-hour Holter monitor (heart monitor)
* Cardiac catheterization
* Chest x-ray
* ECG
* Echocardiography (the most common test) with Doppler ultrasoundDoppler ultrasound
* MRI of the heart
* Transesophageal echocardiogram (TEE)
Not all of these tests are useful for evaluating all of these conditions.
Blood tests may be done to rule out other possible diseases.
If you are diagnosed with hypertrophic cardiomyopathy, your health care provider may recommend that your close blood relatives (family members) be screened for the condition.
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. Some medications used include beta-blockers and calcium channel blockers, which may reduce chest pain and other symptoms, particularly with 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 done. This procedure cuts and removes a portion of 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), essentially causing a controlled heart attack.
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