Hypertrophic cardiomyopathy (HCM) is a condition where the heart muscle becomes abnormally thick (hypertrophied). The thickened heart muscle makes it difficult for the heart to pump blood and function. This condition often goes undiagnosed as many people with the disease do not have any symptoms and can lead normal lives without any problems. However, in very few people with hypertrophic cardiomyopathy, it can cause shortness of breath, chest pain, defects in the heart’s electrical signalling, which may result in lethal abnormal heart rhythms (arrhythmias) or sudden death.
Symptoms
Some of the signs and symptoms associated with hypertrophic cardiomyopathy may include:
Chest pain, mainly during exercise.
Fainting, particularly during or just after workout or exertion.
Heart murmur, which physician may listen to while examining the patient.
A sensation of rapid, pounding heartbeats (palpitations).
Shortness of breath, especially during a workout.
Several conditions can cause shortness of breath and heart palpitations. Thus, it is essential to get prompt screening and treatment. Consult your healthcare provider if you have a family history of HCM. Seek immediate medical help if you have any of the following symptoms for more than a few minutes:
Rapid or irregular heartbeat
Difficulty breathing
Chest pain
Causes
Hypertrophic cardiomyopathy is generally caused by abnormal genetic mutations that cause the heart muscle to grow abnormally thick. In most people with this condition, the muscular wall between the two bottom chambers of the ventricles becomes thicker than normal. As a result, the thicker heart muscle wall may hinder blood flow out of the heart, and this is condition is called hypertrophic cardiomyopathy.
If there’s no significant blocking of blood flow, the condition is called nonobstructive hypertrophic cardiomyopathy. The heart’s main pumping chamber (left ventricle) may become stiff, and this makes it difficult for the heart to relax and decreases the amount of blood the ventricle can hold and send to the body with every heartbeat.
People with HCM also have an abnormal arrangement of heart muscle cells and this may trigger arrhythmias.
Risk Factors
The risk of hypertrophic cardiomyopathy is passed down through families(inherited).
If one of the parent has hypertrophic cardiomyopathy, then you may have a 50% chance of having the genetic mutation for the disease.
Children or siblings of a person with hypertrophic cardiomyopathy must consult their physician about necessary screening.
Complications
Atrial Fibrillation: Thickened heart muscle, as well as abnormal structure of heart cells, can cause changes in the heart’s electrical system, resulting in irregular heartbeats. Atrial fibrillation can also increase a person risk of developing blood clots, that may reach the brain and cause a stroke.
Blocked Blood Flow: In most people, the thickened heart muscle blocks the blood flow resulting in shortness of breath while doing any activity, chest pain, dizziness, and fainting.
Mitral Valve Problems: When the blood flow leaving the heart is blocked, the valve between the left atrium and left ventricle (mitral valve) may not close properly, as a result, blood can leak backwards into the left atrium (mitral valve regurgitation), which may worsen the symptoms.
Dilated Cardiomyopathy: In a few people with HCM, the thickened heart muscle may become weak. The ventricle becomes enlarged(dilated) and pumping ability becomes less
Heart Failure: People with HCM the heart muscle may eventually become stiff, as a result, the heart cannot efficiently pump blood to meet the body’s needs.
Also Read: Heart Failure: Symptoms, Causes, Types And Treatment
Sudden Cardiac Death: Hypertrophic cardiomyopathy can cause heart-related sudden death in people of all ages. As most people don’t realize they have it, sudden cardiac death may be the first sign of a problem. However, it can also develop in healthy young adults including athletes and active adults.
Diagnosis
The doctor will thoroughly examine the person and enquire about signs, symptoms, and medical and family history. Some of the tests suggested by the doctor to confirm the diagnose or rule out other conditions that can cause similar symptoms include:
Echocardiogram: An echocardiogram is usually used to diagnose HCM. The test uses sound waves to check if the heart’s muscle is abnormally thick and shows how heart chambers and valves are pumping blood.
Exercise stress tests are also generally suggested to diagnose a person with HCM.
Electrocardiogram (ECG): An ECG can show abnormal heart rhythms and signs of heart thickening. For some patient’s, a portable ECG machine called a Holter monitor is connected to record patient heart’s activity continuously for one to two days.
Also Read: Electrocardiogram (ECG) Test: Procedure, Results And Risks
Cardiac MRI: This test uses strong magnets and radio waves to create images of the heart and provides information about heart muscle and show how heart and heart valves work.
Treatment
The main goal of hypertrophic cardiomyopathy treatment is to ease symptoms and avert sudden cardiac death in people at high risk. Treatment options mainly depend upon the severity of the symptoms.
Medications are prescribed to minimize how strong heart muscle squeezes and slow the heart rate so that heart can pump blood better. Beta-blockers, calcium channel blockers, heart rhythm drugs and blood thinners are prescribed to avert blood clots and enhance heart pumping.
Surgeries
Different kind of surgeries or procedures are available to treat cardiomyopathy and alleviate symptoms. They range from open-heart surgery to implantation of a device to control heart rhythm.
Septal Myectomy: This surgery may be suggested if the medication does not improve symptoms, it involves removing part of the thickened wall between the heart chambers. this surgery improves blood flow out of the heart and reduces the backward flow of blood via the mitral valve.
Septal Ablation: this surgery destroys the thickened heart muscle with alcohol. The alcohol is injected via a long thin tube into the artery supplying the blood to that area.
Implantable cardioverter-defibrillator (ICD): An ICD is a small machine that continuously monitors heartbeat and it’s implanted in the chest like a pacemaker. In case of life-threatening arrhythmia, The ICD delivers accurate electrical shocks to restore a normal heart rhythm.
