Hypertrophic cardiomyopathy: Overview
Hypertrophic cardiomyopathy (say "hy-per-TROH-fik kar-dee-oh-my-AWP-uh-thee") is a disease in which the heart muscle grows too thick. Many people have no symptoms and live a normal life with few problems. But some people can have problems. The thickened heart muscle can make it hard for the heart to pump blood well. This can cause shortness of breath, chest pain, dizziness, fainting, and fatigue. It also can affect the heart's electrical system. For some people, this can increase the risk for life-threatening abnormal heartbeats. Based on your risk, a device called an ICD (implantable cardioverter-defibrillator) may be an option. This device can stop these abnormal heartbeats.
Good care at home can help you cope with symptoms and get the best results. It is very important that you follow up with your doctor.
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy is a genetic disease in which the heart muscle grows abnormally, making the heart muscle thicken. The thickened heart muscle can interfere with the heart's electrical system, which increases the risk for life-threatening abnormal heartbeats (arrhythmias) and, rarely, sudden death.
Symptoms, such as shortness of breath and chest pain, may occur at any time of life. But some people never have symptoms, even though the condition may have been present for some time. In some cases, the thickened heart muscle is unable to relax between heartbeats, and the heart muscle itself does not get enough blood or oxygen, which causes chest pain. In rare cases, the thickened heart muscle becomes unable to pump enough blood to meet the body's needs, resulting in heart failure.
What are the symptoms of hypertrophic cardiomyopathy?
You may not have any symptoms. Or you might:
- Feel tired and short of breath when you are active.
- Have chest pain. You may have a heavy, tight feeling in your chest. Chest pain is often brought on by exercise, when the heart has to work harder.
- Feel dizzy or faint, often after you have been active.
- Feel like your heart is pounding, racing, or beating unevenly (palpitations).
What are the types of hypertrophic cardiomyopathy?
Hypertrophic cardiomyopathy is a genetic disease in which the heart muscle grows abnormally, making the heart muscle thicken. Hypertrophic cardiomyopathy is described as either obstructive or nonobstructive.
- Nonobstructive hypertrophic cardiomyopathy.
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The heart muscle is abnormally thick but not to the extent that any part of it crowds the lower heart chambers (ventricles). The thicker muscle simply cannot relax properly. This means that less blood can enter the chambers and less blood is circulated to the body.
- Obstructive hypertrophic cardiomyopathy.
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Portions of the heart muscle become so thick that they bulge out into the lower heart chambers (ventricles). Blocked blood flow and smaller, less effective ventricles result, especially during exercise, when the heart has less time to relax and fill. Thickened heart muscle may also interfere with how the heart valves open and close, particularly the mitral valve, which divides the left upper chamber (atrium) from the left ventricle.
How is hypertrophic cardiomyopathy treated?
Many people who have hypertrophic cardiomyopathy don't have symptoms and don't need treatment. If the condition causes symptoms or more serious heart problems, treatment may include medicines, a device called an implantable cardioverter-defibrillator (ICD), or procedures to reduce the size of the overgrown part of your heart.
How is hypertrophic cardiomyopathy diagnosed?
Your doctor may use tests such as an echocardiogram, electrocardiogram (ECG or EKG), chest X-ray, and MRI to help diagnose this condition. A physical exam and your family history of heart disease and other problems are also important.
Caring for yourself when you have hypertrophic cardiomyopathy
There are several things you can do to be safe and stay healthy when you have hypertrophic cardiomyopathy.
- Take your medicines exactly as prescribed.
Call your doctor if you think you are having a problem with your medicine.
- Do not smoke.
If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
- Eat heart-healthy foods.
These include fruits, vegetables, whole grains, fish, lean meats, and low-fat or nonfat dairy foods. Limit sodium, sugars, and alcohol.
- Drink plenty of fluids (unless your doctor has told you to limit your fluid intake).
- Be active at a safe level.
Try to exercise on most, if not all, days of the week. Ask your doctor what level of exercise and what kinds of activities are safe for you. You may need to avoid strenuous activity.
- Stay at a healthy weight.
Lose weight if you need to.
- Manage other health conditions such as high blood pressure and high cholesterol.
- Get checkups as often as your doctor recommends.
- Avoid infections such as COVID-19, colds, and the flu.
Get the flu vaccine every year. Get a pneumococcal vaccine. If you have had one before, ask your doctor whether you need another dose. Stay up to date on your COVID-19 vaccines.
What is the risk of sudden death with hypertrophic cardiomyopathy?
Some people who have hypertrophic cardiomyopathy are at high risk for sudden death. It can occur at any age, but it is most shocking when it happens to young adults or athletes. While the media often highlight these tragic deaths, sudden death is rare. It occurs in about 1 out of 100 adults with hypertrophic cardiomyopathy each year.
Sudden death is often the result of ventricular tachycardia (a type of rapid heart rate) or other dangerous arrhythmias, which can be caused by hypertrophic cardiomyopathy.
To find out your risk of sudden death, your doctor will do tests and ask you about your health and family history. Your doctor might check to see if you:
- Have had cardiac arrest or ventricular tachycardia in the past.
- Had a close relative who had hypertrophic cardiomyopathy and died suddenly.
- Have fainted (syncope).
- Have had low blood pressure during or after exercise.
- Have extreme left ventricle thickness (more than 30 millimeters).
If you are at high risk for sudden death, an implantable cardioverter-defibrillator (ICD) might be right for you. An ICD can identify life-threatening arrhythmias and successfully restore a normal heartbeat.
Because of the possible increased risk of sudden death, it may be a good idea for family members of people who have hypertrophic cardiomyopathy to learn CPR (cardiopulmonary resuscitation).
What is hypertrophic cardiomyopathy?
Hypertrophic cardiomyopathy (say "hy-per-TROH-fik kar-dee-oh-my-AWP-uh-thee") happens when the heart muscle grows too thick. Many people with this condition have no symptoms and live a normal life with few problems. But in some people, it can cause more serious heart problems and in rare cases can cause sudden death.
What causes hypertrophic cardiomyopathy?
Hypertrophic cardiomyopathy is usually passed down through families. Certain genes cause the heart to grow more than it should.
Hypertrophic cardiomyopathy: When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You have symptoms of a heart attack. These may include:
- Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
- Lightheadedness or sudden weakness.
- You have severe trouble breathing.
- You cough up pink, foamy mucus and you have trouble breathing.
- You passed out (lost consciousness).
Call your doctor now or seek immediate medical care if:
- You have new or increased shortness of breath.
- You are dizzy or lightheaded, or you feel like you may faint.
- You have sudden weight gain, such as more than 2 to 3 pounds in a day or 5 pounds in a week. (Your doctor may suggest a different range of weight gain.)
- You have increased swelling in your legs, ankles, or feet.
- You have an ICD and you have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the cut (incision).
- Pus draining from the incision.
- A fever.
- You have a sudden episode of a skipping heartbeat or a very fast heartbeat.
Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.
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