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Hypertrophic Cardiomyopathy

What is hypertrophic cardiomyopathy? 

Hypertrophic cardiomyopathy is any disease of the heart muscle in which the heart loses its ability to pump blood effectively. It occurs when the muscle mass of the left ventricle of the heart is larger than normal, or the wall between the two ventricles (septum) becomes enlarged and obstructs the blood flow from the left ventricle. Because it prevents the heart from properly relaxing between beats, it fills with less blood, which limits the amount of blood pumped by the heart with each beat.

Hypertrophic cardiomyopathy is a rare disease and in most cases it is inherited. 

Risks of Hypertrophic Cardiomyopathy

Viral infections that infect the heart are a major cause of cardiomyopathy. In some instances, cardiomyopathy is a result of another disease or its treatment, such as complex congenital (present at birth) heart disease, nutritional deficiencies, uncontrollable, fast heart rhythms, or certain types of chemotherapy for cancer. Sometimes, cardiomyopathy can be linked to a genetic abnormality. Other times, the cause is unknown.

Hypertrophic cardiomyopathy occurs when the muscle mass of the left ventricle of the heart is larger than normal, or the wall between the two ventricles (septum) becomes enlarged and obstructs the blood flow from the left ventricle. Because it prevents the heart from properly relaxing between beats, it fills with less blood, which limits the amount of blood pumped by the heart with each beat.

Dilated Cardiomyopathy

Dilated cardiomyopathy is the most frequent form of non-ischemic cardiomyopathy. The cavity of the heart is enlarged and stretched (cardiac dilation) causing the heart to become weak and not pump normally.

  • This occurs most often in middle-aged people and more often in men than women, but has been diagnosed in people of all ages, including children.
  • Most patients develop congestive heart failure.
  • Dilated cardiomyopathy can be caused by chronic, excessive consumption of alcohol along with dietary deficiencies.
  • It occasionally occurs as a complication of pregnancy and childbirth.
  • Other suggested causes are various infections (mostly viral, which lead to an inflammation of the heart muscle, called myocarditis), toxins, and (rarely) heredity. Sometimes drugs used to treat a different medical condition can damage the heart and produce dilated cardiomyopathy. However, in most cases, a specific cause for the damage is never identified.

Restrictive Cardiomyopathy

Restrictive cardiomyopathy, the least common type of cardiomyopathy in the US, occurs when the myocardium of the ventricles becomes excessively rigid, and the filling of the ventricles with blood between heart beats is impaired.

  • It usually results from another disease which occurs elsewhere in the body.
  • Restrictive cardiomyopathy does not appear to be inherited, but some of the diseases that lead to the condition are genetically transmitted.
  • Symptoms may include fatigue, swelling of the extremities, and difficulty breathing on exertion.

What are the causes of hypertrophic cardiomyopathy? 

Viral infections that infect the heart are a major cause of cardiomyopathy. In some instances, cardiomyopathy is a result of another disease or its treatment, such as complex congenital (present at birth) heart disease, nutritional deficiencies, uncontrollable, fast heart rhythms, or certain types of chemotherapy for cancer. Sometimes, cardiomyopathy can be linked to a genetic abnormality. Other times, the cause is unknown.

What are the symptoms of hypertrophic cardiomyopathy?

One or more of the following symptoms may be indicative of hypertrophic cardiomyopathy?

  • chest pain, especially during exercise
  • fainting, especially during or just after exercise or exertion
  • heart murmur
  • rapid or fluttering heart beats
  • shortness of breath on exertion

How to diagnose hypertrophic cardiomyopathy?

Hypertrophic cardiomyopathy may be diagnosed with one or more of the following tests:

  • electrocardiogram (EKG)
  • echocardiogram
  • chest x-ray
  • cardiac catheterization
  • genetic testing

How to treat hypertrophic cardiomyopathy?

There are several treatment options available including the following:

Medications.  Your physician will determine the best medication(s) to provide you to help with the symptoms you are experiencing.

Alcohol septal ablation. Cardiologists specializing in alcohol septal ablation treatment use a catheter to inject alcohol into the specific area of the heart to destroy the thickened part of the heart muscle.

Surgical septal myectomy.  A cardiac surgeon will perform a minimally invasive cardiac surgery or an open-heart procedure to remove part of the thickened septum which is the area between the ventricles.