Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is a disease which involves abnormal thickening of the heart muscles. Usually, only one part of the heart muscles becomes thick. This makes it difficult for the heart to pump blood efficiently. It is a common medical condition which can affect people of any age group.

Causes

Hypertrophic cardiomyopathy is passed through generations and is due to the defect in the genes which control the muscle growth of the heart. In some patients, the cause is unknown. There is a 50% chance of the child inheriting hypertrophic cardiomyopathy if any one of the parents has the condition.

Symptoms

Most of the people with hypertrophic cardiomyopathy cannot identify that they have a heart problem as they do not have any associated symptoms.

In young adults, the first symptom is a sudden collapse and sometimes death. This is due to the blockage of blood flow out of the heart or due to abnormal heart rhythms.

Few cardiomyopathy symptoms include:

  • Chest pain
  • Dizziness and lightheadedness
  • Fainting (especially while exercising)
  • Fatigue
  • Palpations (i.e. feeling the heart beats more prominently)
  • Shortness of breath

Risk factors

Both men and women are at equal risk for hypertrophic cardiomyopathy.

People of all the age groups get affected with hypertrophic cardiomyopathy. However, younger people have an increased risk of having a more severe form of the disease.

Complications

Only some patients with hypertrophic cardiomyopathy experience significant health problems which include:

Arrhythmias: Due to the thickening of the heart muscles, impairment in the production of the electrical impulses from the heart occurs. This causes fast and irregular heartbeats. Atrial fibrillation (abnormally high heart beat) can lead to the formation of clots which travel to the brain causing a stroke.

Blood flow obstruction: This can lead to shortness of breath with exertion, dizziness, chest pain, and fainting.

Heart failure: As the ability of the heart to fill adequately decreases, the amount of blood pumped by the heart also is not enough to meet the body’s demand.

Sudden cardiac death: People with hypertrophic cardiomyopathy are at an increased risk for sudden cardiac death, but such deaths are, however, rare (only in 1% of the patients).

Complications of the heart valves are also possible which disrupt the normal blood flow.

Diagnosis

Initially, a physical examination is performed using a stethoscope to check for the presence of abnormal heart sounds such as murmurs and to check the blood pressure.

Tests which are performed to diagnose the thickening of the heart muscles, blow flow problems or valve defects include:

  • Echocardiography
  • ECG (Electrocardiography)
  • 24-hour Holter monitor (heart rhythm monitor)
  • Cardiac catheterization
  • Chest x-ray
  • Trans-esophageal echocardiogram (TEE)

Other imaging modalities that are used include:

  • Radionuclide imaging
  • Chest radiography
  • Cardiac MRI

Treatment

Symptomatic relief is provided by the medicines such as calcium-channel blockers and beta-blockers. These drugs maintain the normal contraction and relaxation of the heart. They also relieve chest pain (angina) and shortness of breath.

Patients with arrhythmias may require anti-arrhythmic drugs and/or blood thinners to reduce the risk of blood clots and/or a permanent pacemaker to control the heartbeat.

If there is a severe blockage in the blood flow out of the heart, it can worsen the symptoms. In such patients, surgical myectomy is performed. Some people also are found to show improvement with alcohol septal ablation, i.e. the injection of alcohol into the thickened heart muscle.

If there is a leakage through the valves, surgical repair is warranted.

Self-management

Regularly consult your doctor for checkups. Certain lifestyle changes are recommended during and after the treatment which include:

Diet: You may have to restrict the salt content in your diet. You should drink at least 6-8 glasses of water each day. Follow the nutrition guidelines as suggested by your doctor.

Exercise: Whether to exercise or not is based on your symptoms and disease severity. Do not lift heavy weights. You should avoid strenuous exercises and perform simple exercises as suggested by your doctor.