Hypertrophic cardiomyopathy (HCM) is a heart condition that makes it difficult for the heart to pump blood. If you or a loved one has been diagnosed, it’s important to know what questions to ask your care team.
Hypertrophic cardiomyopathy (HCM) is a type of heart condition that causes the walls of the heart’s main pumping chamber (left ventricle) to abnormally thicken and enlarge.
This can make the heart muscle less flexible and decrease its ability to take in and pump out blood as it beats.
Since HCM is a lifelong (chronic) condition, it’s important to stay in touch with your doctor and other members of your healthcare team. Consider the following questions to help you get the conversation started.
HCM is most often hereditary. It’s thought to be caused by abnormal genes within the heart muscle, which leads to enlargement and thickening of the left ventricle.
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HCM is a type of heart disease that can run in families. If you have a parent or other close relative with a history of heart disease, it’s a good idea to ask your doctor about your risk of developing HCM.
Additionally, if you’re diagnosed with HCM, you may consider talking with your child’s doctor about their risks. Consider discussing your diagnosis with your parents or siblings so they can talk with their doctors, too.
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There are two types of HCM: obstructive and nonobstructive.
Obstructive HCM is the most common type. If you’re diagnosed with obstructive HCM, this means that the left ventricle has thickened to a point where blood flow through the aorta, the heart’s primary artery, is obstructed.
If you have nonobstructive HCM, you may have thickening in the heart muscle, but it has not developed to a point where blood flow is blocked.
HCM does not always cause symptoms, which is why some people may not realize they have this heart condition until a doctor finds it.
When symptoms do occur, they may be mild at first, or they might develop over time as your condition progresses. Symptoms can include:
- irregular heartbeat (arrhythmia)
- chest pain
- fatigue
- shortness of breath
- dizziness or fainting
- swelling in your abdomen or lower extremities
The primary HCM treatment goal is to help reduce symptoms while possibly preventing complications. This is mostly the case in obstructive forms of the disease.
HCM treatment options may include:
- heart-rate lowering medications, such as beta-blockers or calcium channel blockers
- mavacamten (Camzyos), a medication FDA-approved
in 2022 for treating obstructive, symptomatic HCM - implantable cardioverter-defibrillator (ICD), a device used to monitor and treat potentially dangerous arrhythmias
It’s possible to experience side effects from certain medications used to treat HCM.
Heart-rate lowering medications may cause:
- dizziness
- headaches
- stomach discomfort
- swelling in your lower extremities
- fatigue
- erectile dysfunction
Dizziness and fainting are also possible side effects of taking Camzyos for obstructive HCM.
Since these side effects are similar to HCM symptoms, it’s important to report any new symptoms to your care team. They can help determine whether it’s a medication side effect or a sign that your HCM is progressing.
Also, do not stop taking any prescription medications without discussing them with your care team first. HCM treatments are important in reducing your risk of potentially life threatening complications like heart attack and stroke.
Surgery is only considered if you’re experiencing severe symptoms of heart failure resulting from HCM despite treatment.
Open heart surgery may be an option if you have a significant obstruction and your symptoms do not improve with medications and lifestyle changes.
Septal myectomy is an open heart surgery where a surgeon removes part of the thickened heart muscle.
Alcohol septal ablation is a less invasive treatment that cardiologists perform. During the procedure, a catheter is threaded into the heart, and alcohol is injected to cause scarring and reduce the size of the thickened septum.
A heart transplant might only be considered if you have end stage heart disease.
In addition to treatment, your doctor may recommend dietary and exercise modifications.
From a dietary standpoint, they may recommend eating more plant-based foods and limiting sugar, saturated fats, and added salt. You might also consider eating a Mediterranean diet, which focuses on fruits and vegetables, whole grains, olive oil, and fish. Staying well hydrated and avoiding dehydration are also important.
A regular exercise program is also considered part of a heart-healthy lifestyle. But with HCM, a doctor may recommend focusing on moderate workouts, such as walking, instead of vigorous ones that could place a further strain on your heart.
Discuss any type of competitive sport or more vigorous exercise with your doctor before participating.
You may also benefit from other lifestyle changes that can help your heart as well as your overall health. Talk with your doctor about:
- maintaining a moderate body weight
- stress management
- how much sleep is ideal for you
- quitting smoking if you smoke
- whether it’s safe to drink alcohol moderately
While an HCM diagnosis can understandably cause concern, it’s important to know that most people with this condition have a positive long-term outlook. With treatments and lifestyle changes, a person can also reach what’s scientifically considered the typical life expectancy.
It’s important to note that some people might be more susceptible to severe heart-related complications with HCM. Talk with your doctor about such risks, especially if you have a family history of heart attack, stroke, or cardiac arrest.