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Hypertrophic cardiomyopathy, or HCM, is a disease that causes thickening (hypertrophy) of the heart muscle. The heart muscle cells enlarge more than they should and scarring often develops between the cells.
The left and right ventricles are the 2 lower chambers of the heart. A muscular wall called the septum separates these 2 ventricles. With HCM, the walls of the ventricles and septum may thicken abnormally.
The thickened septum may bulge into the left ventricle and partially block the blood flow out to the body. This is called obstructive hypertrophic cardiomyopathy. When this happens, the heart must work harder to get the blood out to the body.
Because of thickened heart muscle, the inside of the left ventricle is smaller, so it holds less blood than normal. The ventricle can also become very stiff. As a result, it is less able to relax and fill with blood.
HCM can also damage the mitral valve, which can increase pressure in the ventricles. This can cause fluid to build up in the lungs. The abnormal heart cells in HCM can also set off abnormal heart rhythms.
HCM is a common condition. It affects the same numbers of men and women. In most cases, the symptoms first appear during adolescence or young adulthood.
HCM is a genetic problem that you inherit from your parents. It leads to the thickening of the left ventricle. How exactly this happens is not yet clear.
HCM is autosomal dominant. This means you need an abnormal gene from only one of your parents to have it. But even if you have an abnormal gene, you might not develop HCM. Researchers are still trying to understand what other factors increase the chances of having the disease.
Having a first degree relative with HCM puts you at risk for the disease. A parent with an abnormal gene for this condition, has a 50% chance of giving that gene to a child. If someone in your immediate family has HCM, specific screening protocols should be followed. Screening typically includes a history, physical exam, electrocardiogram (ECG) and an echocardiogram. Genetic testing is available, but this is not routinely recommended for screening and diagnosis.
Most people with HCM have few or no symptoms. Symptoms most commonly appear during adolescence or young adulthood. The onset and severity of symptoms varies among those with the condition. These may include:
Your healthcare provider will take your medical history and do a physical exam, noting any heart murmurs. Several tests may also help in the diagnosis. These tests include:
If a person has HCM, other members of the family should be tested. This includes all the siblings, parents, and children of the person diagnosed with the disease.
Treatment for HCM aims to decrease symptoms and the chance of complications. The best treatment for you will depend on your specific symptoms. Some general types of treatment include:
Septal myectomy and alcohol septal ablation may be done in people with severe symptoms or complications that do not improve with medicines. Both procedures help blood exit the left ventricle more easily.
Most people with HCM do not have complications. But some do, especially if their disease is more severe. These complications may include:
Sudden death is rare in people with HCM. If you are at risk for sudden death, your healthcare provider may recommend an implantable cardioverter-defibrillator (ICD).
Your healthcare provider may give you additional instructions about how to manage your HCM.
See a healthcare provider right away if you have severe symptoms like chest pain, passing out, or severe shortness of breath. If your symptoms are gradually increasing, plan to see your healthcare provider soon. Make sure all of your healthcare providers know about your medical history.
HCM causes abnormal growth of the heart muscle. Most people with HCM have few or no symptoms. Most lead long lives. But HCM sometimes causes serious complications, including sudden cardiac death.
Tips to help you get the most from a visit to your healthcare provider:
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