Hypertrophic Cardiomyopathy is a disease in which the patient’s heart muscle becomes thickened and enlarged. This thickened heart muscle can make it difficult for the heart to pump blood. This disease usually causes left ventricular stiffness, thickening of heart muscles, and cellular and mitral valve changes.

Many people suffering from this disease are not diagnosed in the early stages because its symptoms are few and do not appear early. This disease usually affects 1 out of 700 people. 

Types of Hypertrophic Cardiomyopathy:

There are two types of following:

  • Obstructive Hypertrophic Cardiomyopathy:

In obstructive cardiomyopathy, the wall (septum) between the heart’s two bottom chambers(ventricles) thickens and obstructs the blood flow from the left ventricles to the aorta.

  • Non-obstructive Hypertrophic Cardiomyopathy:

The heart muscle in non-obstructive hypertrophic cardiomyopathy is thickened, but it doesn’t block blood flow out of the heart.

Causes of Hypertrophic Cardiomyopathy:

There are many causes of this disease. Some of them are the following:

  • Hypertrophic Cardiomyopathy is mainly caused by changes in genes, which causes the heart muscle thickened. These genes can be inherited from parents to children. An individual with one parent with this disease has a higher chance of genetic mutation for hypertrophic cardiomyopathy.  
  • Aging is another cause of Hypertrophic Cardiomyopathy. This problem usually develops in a person’s teens but usually affects him after 35 or 40. 
  • High blood pressure can also cause hypertrophic cardiomyopathy.

The cause of hypertrophic cardiomyopathy sometimes is unknown. 

Symptoms of Hypertrophic Cardiomyopathy:

Some common symptoms of hypertrophic cardiomyopathy include:

  • Chest pain, especially after physical activity
  • Shortness of breath during physical activity
  • Irregular heart rhythms
  • Murmuring of heart
  • Dizziness or Fainting, especially after exertion or physical activity
  • Palpitations

When to see a doctor:

Getting an accurate diagnosis and appropriate care for this disease is essential. Contact the doctor immediately if someone notices shortness of breath, irregular Heartbeat, and chest pain, or if he has any family history of Hypertrophic Cardiomyopathy.

Diagnosis:

Hypertrophic Cardiomyopathy can affect a person at any age, but it is usually diagnosed in middle age because its symptoms don’t appear early. A cardiologist or pediatric cardiologist usually diagnoses hypertrophic cardiomyopathy. The diagnosis of Hypertrophic Cardiomyopathy is generally based on the patient’s family history, medical history, physical exam, and diagnostic test results.

  • Medical and family history:

During diagnosis, the doctor may ask about the patient’s medical history to detect the disease’s symptoms. The doctor may also ask about the family history of patients’ parents or siblings suffering from heart failure or cardiac arrest. Hypertrophic Cardiomyopathy usually transfers from parents to the children. 

  • Physical trail:

During the physical trial, the doctor will listen to the heart and lungs with the help of the stethoscope. He will test further if he observes changes or detects any heart blood flow restriction.

  • Diagnosis test:

The next step of the diagnosis is diagnosis testing, which usually takes place with the help of an echocardiogram that checks the heart muscle thickness and blood flow in the heart. In rare cases, a transesophageal echo (TTE)can also be recommended by a doctor to diagnose the condition of the heart. Other diagnostic tests may include:

  • Genetic testing
  • Stress tests
  • Electrocardiogram (ECG)
  • Cardiac magnetic resonance imaging (MRI)
  • Holter and event monitors to diagnose arrhythmias
  • Cardiac Catheterization 

Treatment:

  • The treatment of hypertrophic cardiomyopathy usually depends on arrhythmias, outflow obstruction, activity level, and heart functioning changes. The treatment methods generally aim to treat symptoms and prevent further complications. Some medications, lifestyle changes, and medical procedures help to treat hypertrophic cardiomyopathy. 
  • Medications:

The medications that help to treat Hypertrophic Cardiomyopathy may include calcium channel blockers, beta-blockers, diuretics, and antiarrhythmics. These medications are helpful in the proper functioning of the heart but also have side effects.

  • Medical procedures:

Surgical and non-surgical procedures are also helpful in treating hypertrophic cardiomyopathy. These procedures include:

  • Septal myectomy (surgical procedure):

Septal myectomy is also known as open heart surgery. The healthcare provider may consider this procedure if medications are not working. During septal myectomy, the surgeon will remove that part of the thickened septum bulging into the left ventricles. This process removes obstruction and improves blood flow in the heart.

  • Alcohol septal ablation (non-surgical procedure):

Alcohol septal ablation is non-surgical reduction therapy. The doctor injects ethanol (alcohol) into a small tube in arteries affected by hypertrophic cardiomyopathy. This alcohol kills the cells on contact and reduces the size of thickened tissues to a usual extent; this process improves the blood flow in the patient’s heart.

  • Cardiac implantable electronic devices:

Many devices can help in better functioning of the heart:

Pacemaker: This small device controls irregular arrhythmias and helps to remain the heart beating at an average rate. It is usually recommended for people having a slow heartbeat rate.

Cardiac resynchronization therapy (CRT) device: This device helps to remain the Heartbeat at the right rhythm and restore the regular timing pattern of the Heartbeat.

Implantable cardioverter defibrillator (ICD): The ICD helps to maintain a regular heartbeat by sending an electric shock to the heart. And decreases the risk of sudden cardiac death.

  • Heart transplant:

The doctor may suggest a heart transplant when the patient has advanced end-stage Hypertrophic Cardiomyopathy. During this process, the deceased heart of a patient is replaced with a healthy heart. 

  • Lifestyle changes:

If someone is suffering from hypertrophic cardiomyopathy, the doctor may recommend the following lifestyle changes to reduce the risk factors:

  • Maintain a healthy diet
  • Limit the use of alcohol
  • Maintain healthy body weight
  • Performing low-intensity physical activities like walking or golfing
  • Avoid high-impact exercise

Risk factor:

The only risk factor for hypertrophic cardiomyopathy disease is genetics. Hypertrophic Cardiomyopathy is usually passed down in families. 

Complications:

If the hypertrophic cardiomyopathy gets complicated, the patient might face:

  • Atrial fibrillation
  • Restriction in blood flow
  • Mitral valves diseases
  • Irregular Heartbeat and Fainting
  • Dilated Cardiomyopathy
  • Heart failure
  • Sudden cardiac death

Preventions:

There is no  well known prevention for hypertrophic cardiomyopathy. One might be referred for genetic testing to screen for the condition if the patient’s parents or siblings suffer from this disease. Early detection and treatment of this disease help to prevent complications.

References:

  • https://www.heart.org/en/health-topics/cardiomyopathy/what-is-cardiomyopathy-in-adults/hypertrophic-cardiomyopathy
  • https://www.mayoclinic.org/diseases-conditions/hypertrophic-cardiomyopathy/symptoms-causes/syc-20350198#:~:text=Hypertrophic%20cardiomyopathy%20(HCM)%20is%20a,few%2C%20if%20any%2C%20symptoms.
  • https://my.clevelandclinic.org/health/diseases/17116-hypertrophic-cardiomyopathy
  • https://www.healthline.com/health/hypertrophic-cardiomyopathy
  • https://www.webmd.com/heart-disease/guide/hypertrophic-cardiomyopathy