Hypertrophic Cardiomyopathy – HCM

What is hypertrophic cardiomyopathy? — Hypertrophic cardiomyopathy is a condition that causes the muscle in the heart to get too bulky (figure 1). When this happens, the heart can have trouble pumping blood as well as it should. This can lead to symptoms, such as trouble breathing, chest pain, and fainting. Hypertrophic cardiomyopathy is caused by a genetic problem that runs in families.

What are the symptoms of hypertrophic cardiomyopathy? — Most people with hypertrophic cardiomyopathy have no symptoms. When symptoms do occur, they can start during childhood, the teenage years, or adulthood.

Symptoms can include:

Trouble breathing, especially during exercise

Trouble breathing that gets worse when you lie down and gets better if you sit up or stand

Chest pain, which sometimes gets worse with activity

Fainting or feeling like you might faint

Feeling as though your heart is beating very fast or skipping beats

Swelling in the feet, ankles, or legs

Is there a test for cardiomyopathy? — Yes. If your doctor or nurse suspects you have cardiomyopathy, he or she will probably order an “electrocardiogram” (also called an “ECG” or “EKG”) (figure 2). This test measures the electrical activity in your heart. It can show if your heart beats in a normal pattern and rhythm.

Your doctor might also order an “echocardiogram” (or “echo” for short) (figure 3). An echo uses sound waves to create an image of the heart. This test allows doctors to measure the thickness of the walls of the heart, measure the size of the spaces inside the heart — called chambers — and see how the heart pumps. Depending on your situation, you might also need other tests. Since hypertrophic cardiomyopathy runs in families, your doctor or nurse might suggest testing your family members for the disorder, too.

What problems can hypertrophic cardiomyopathy cause? — In many cases the condition causes no problems. But in some cases it can lead to:

Heart failure, a condition in which the heart does not pump as well as it should

Heart rhythm disorders

Heart block, a problem that keeps electrical signals from moving through the heart as they should

Stroke

Infection of a heart valve

Death

How is hypertrophic cardiomyopathy treated? — Many people with hypertrophic cardiomyopathy do not need treatment. Those who do need treatment can get different kinds depending on what symptoms they have and how severe their condition is.

Treatments can include:

Medicines to relieve chest pain or trouble breathing

Medicines to control the heart’s rhythm

Surgery to implant a device called an “implantable cardioverter-defibrillator,” or “ICD.” (This device keeps the heart beating normally.)

Surgery or other treatments to remove parts of the heart muscle. (This is done only when medicines do not work.)

What if I want to get pregnant? — Talk to your doctor before you start trying to get pregnant. Most women with hypertrophic cardiomyopathy are able to have normal pregnancies. But some need to change their medicines before they start trying to have a baby.

Is there anything I can do on my own to protect my heart and my health? — Yes. You should be careful to always drink enough water. People with hypertrophic cardiomyopathy sometimes have problems, such as fainting, when they do not get enough fluids. On the other hand, some people with hypertrophic cardiomyopathy have to be careful if they have too much salt and water. Ask your doctor about how much salt is OK to have in your diet.

It’s also important that you ask your doctor what types of physical activity are safe for you. In many cases, people with hypertrophic cardiomyopathy need to avoid some kinds of activity.

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