Hypertrophic Cardiomyopathy (HCM) is a heart condition that influences the heart muscle, making it abnormally thick. This thickening can make it harder for the heart to pump blood efficiently, sometimes leading to serious complications. HCM is often genetic, meaning it can be passed down through families. Although it’s a relatively rare condition, understanding HCM is essential because it can have a major impact on those affected and even lead to sudden heart-related issues if left unchecked.
For many, HCM may not cause any noticeable symptoms and can go undetected for years. In some cases, however, it may cause symptoms like chest pain, shortness of breath, or even fainting, especially during physical activity. These symptoms occur because the thickened heart muscle can obstruct blood flow or make it harder for the heart to relax and fill with blood properly.
Diagnosis of HCM often involves heart imaging tests like an echocardiogram, and treatment may vary depending on the severity of symptoms. While there is currently no cure for HCM, treatments such as medications, lifestyle changes, or even surgery can help manage symptoms and reduce risks. In this blog, we’ll explore the causes, symptoms, and treatment options for hypertrophic cardiomyopathy, along with lifestyle adjustments and support options that can help those living with the condition.
Table of Contents
What Is Hypertrophic Cardiomyopathy?
Hypertrophic Cardiomyopathy (HCM) is a condition where the heart muscle becomes thicker than normal, especially in the walls of the lower chambers, called the ventricles. This thickening can make it harder for the heart to pump blood effectively and can also lead to other issues, depending on how severe the thickening is and where it occurs within the heart.
In a normal, healthy heart, the walls of the heart muscle are smooth and allow blood to flow easily. With HCM, however, the thickened muscle may block or slow down the blood flow out of the heart. This can put extra strain on the heart & sometimes lead to severe symptoms or complications. Think of it like a hose with a clog in it — the pressure behind the clog builds up, making it more difficult for the water to pass through smoothly. In the case of HCM, this “clog” can sometimes make it harder for blood to leave the heart, especially during physical activities.
Why Does Hypertrophic Cardiomyopathy Happen?
HCM is most commonly caused by genetic changes that can be passed down from parents to children. If a parent has HCM, there is about a 50% chance that their child will also inherit the condition. These genetic mutations affect how the heart muscle cells grow, leading to an abnormal thickening of the muscle. However, some people develop HCM without any family history, likely due to random genetic changes.
Hypertrophic Cardiomyopathy Treatment
1. Medications
– What They Do: Medications are often the first line of health treatment for HCM. They can help reduce symptoms like chest pain, shortness of breath, and irregular heartbeat by making the heart work more efficiently.
– Common Medications:
– Beta-blockers: These slow down the heart rate, allowing the heart to fill with blood more effectively between beats.
– Calcium channel blockers: These help relax the heart muscle, reducing stiffness & improving blood flow.
– Anti-arrhythmic drugs: These help control irregular heartbeats.
– Why They’re Used: Medications are useful for many people with HCM, especially if symptoms are mild to moderate. They can often be adjusted based on individual needs and symptoms.
2. Lifestyle Changes
– What They Do: Simple lifestyle changes can help manage symptoms and keep the heart healthy.
– Examples:
– Avoid intense exercise: While light exercise can be good, strenuous activities may put extra stress on the heart.
– Limit alcohol and caffeine: These can trigger irregular heartbeats in some people with HCM.
– Manage stress: High stress can increase heart rate, so practicing relaxation techniques like meditation or deep breathing can help.
– Why They’re Used: These changes help reduce symptoms and may lower the chance of complications, helping people with HCM to live more comfortably.
3. Surgery and Procedures
– What They Do: In cases where symptoms are more severe or medications aren’t helping, surgery or other procedures may be recommended to reduce the thickness of the heart muscle or manage blood flow.
– Types of Procedures:
– Septal Myectomy: This is a surgery where a surgeon removes a part of the thickened heart muscle. It’s most commonly done for people with obstructive HCM to help improve blood flow.
– Alcohol Septal Ablation: In this non-surgical procedure, alcohol is injected into a small artery leading to the thickened part of the heart. This causes a controlled “mini-heart attack” that reduces the size of the muscle over time, making it easier for blood to flow.
– Why They’re Used: These procedures are often used when symptoms are severe and other treatments haven’t worked well. They help relieve pressure in the heart & enhance blood flow, leading to improved symptom control.
4. Implantable Devices
– What They Do: Implantable devices are small machines that help manage the heart’s rhythm, preventing dangerous heart rhythms that could lead to cardiac arrest.
– Types of Devices:
– Implantable Cardioverter Defibrillator (ICD): This is a device that detects dangerous heart rhythms and can deliver a small shock to restore a normal rhythm. ICDs are often used for people at higher risk of sudden cardiac arrest due to HCM.
– Pacemaker: This device can help regulate a slow or irregular heartbeat by sending electrical signals to the heart to keep it beating at a steady rate.
– Why They’re Used: Devices like ICDs and pacemakers are used for those at risk of serious heart complications. They act as a safeguard, helping prevent sudden cardiac events and ensuring a more stable heart rhythm.
5. Heart Transplant
– What It Is: In rare, very severe cases of HCM, a heart transplant may be considered. This involves substituting the damaged heart with a healthy donor heart.
– Why It’s Used: A transplant is only considered if all other treatments have been tried and the person’s symptoms remain severe, with advanced heart failure being present.
Hypertrophic Cardiomyopathy Symptoms
Hypertrophic Cardiomyopathy (HCM) is a heart condition where the heart muscle becomes unusually thick. This can cause a range of symptoms, from mild to severe, and in some people, there may be no noticeable symptoms at all. Here, we’ll look closely at the symptoms of HCM, what causes them, and why they vary from person to person.
Common Symptoms of HCM
1. Shortness of Breath
– What it feels like: People with HCM may find themselves feeling out of breath, especially during physical activities like walking up stairs, exercising, or even doing everyday tasks. In more severe cases, they may feel breathless even at rest.
– Why it happens: The thickened heart muscle makes it harder for the heart to pump blood effectively, and this reduces the amount of oxygen-rich blood reaching the body. The heart’s ability to fill with blood between beats is also limited, meaning less blood gets pumped out with each beat.
2. Chest Pain (Angina)
– What it feels like: Chest pain can vary from a mild, uncomfortable pressure to sharp, intense pain. It can happen during exercise, emotional stress, or even while resting.
– Why it happens: The heart muscle in HCM needs more oxygen due to its extra thickness, but the narrowed blood vessels may not supply enough, leading to pain. Also, the thickened muscle can block blood flow within the heart, contributing to discomfort.
3. Fainting or Dizziness
– What it feels like: People with HCM may feel lightheaded, dizzy, or might even faint, particularly after physical activity or sudden movements.
– Why it happens: If the thickened heart muscle blocks blood flow out of the heart, the brain and other organs might not get enough oxygen-rich blood. Sudden drops in blood flow can cause dizziness or fainting, especially during physical exertion or after standing up quickly.
4. Fatigue
– What it feels like: Fatigue with HCM goes beyond normal tiredness. People may feel constantly tired, even with adequate rest.
– Why it happens: With less efficient blood flow, the body receives less oxygen, leading to feelings of fatigue. The heart is working harder, and the reduced oxygen flow can cause low energy levels throughout the day.
5. Irregular Heartbeat (Arrhythmia)
– What it feels like: Some people with HCM feel their heart racing, fluttering, or beating irregularly, even while at rest. These irregular heartbeats can be fast (tachycardia) or irregular (fibrillation).
– Why it happens: The thickened heart muscle can affect the heart’s electrical signals, leading to arrhythmias. Arrhythmias can sometimes cause complications, like blood clots, and can increase the risk of sudden cardiac arrest in rare cases.
6. Swelling in the Legs, Ankles, and Feet
– What it feels like: People with HCM may notice swelling in their lower legs, ankles, or feet, which can make walking or standing uncomfortable.
– Why it happens: Swelling happens when the heart isn’t pumping efficiently, causing fluid to build up in different parts of the body, especially in the legs and feet. This symptom is more common in cases where HCM has led to heart failure.
Why Symptoms Vary Among People with HCM
Not everyone with HCM experiences symptoms in the same way. Some people may have mild symptoms that they barely notice, while others may experience more serious symptoms that affect their daily lives. Several factors influence the variation in symptoms:
– Severity of the thickening: The more the heart muscle thickens, the more likely it is to cause symptoms.
– Type of HCM: In obstructive HCM, where blood flow is blocked, symptoms like chest pain and fainting are more common.
– Activity level: Physical activity can increase the heart’s workload, which might make symptoms worse.
– Age: Symptoms often appear or worsen with age, as the heart may struggle more to keep up with the body’s needs over time.
If you or someone you know experiences these symptoms, it’s important to see a doctor, especially if the symptoms occur during physical activity. Sudden fainting, severe chest pain, or a racing heartbeat that doesn’t go away may need immediate medical attention, as these could signal a serious heart issue. Hypertrophic Cardiomyopathy may have symptoms that seem similar to those of other heart conditions, so getting a proper diagnosis from a healthcare provider is essential.
Hypertrophic Cardiomyopathy Causes
Hypertrophic Cardiomyopathy (HCM) is usually caused by changes in genes that control the growth of heart muscle cells. These genetic changes can be passed down in families, so if someone has HCM, their children may have a 50% chance of inheriting it.
When there is a genetic mutation (or change) in a person’s DNA, it can make the heart muscle cells grow abnormally thick. This thickening mainly affects the walls of the heart’s main pumping chamber, called the left ventricle, and can lead to the symptoms associated with HCM. Sometimes, though, HCM can occur in people without a family history, due to random genetic changes.
Types Of Hypertrophic Cardiomyopathy
There are two main types of HCM, based on whether the thickened heart muscle blocks blood flow:
1. Obstructive HCM: This is the most common type. In obstructive HCM, the thickened heart muscle partly blocks blood flow out of the heart. This can make it harder for the heart to pump blood, especially during activities that increase the heart’s workload, like exercise. People with obstructive HCM are more likely to experience symptoms like shortness of breath and chest pain.
2. Non-obstructive HCM: In non-obstructive HCM, the thickened heart muscle doesn’t block blood flow out of the heart. However, it still makes the heart stiffer, which can make it harder for the heart to fill with blood between beats. This can also lead to symptoms like fatigue and shortness of breath, but symptoms are often less severe than in obstructive HCM.
Hypertrophic Cardiomyopathy Diagnosis
Diagnosing HCM usually involves several tests that check the structure and function of the heart. Here are the most common methods used:
1. Echocardiogram: This is the primary test for diagnosing HCM. An echocardiogram uses sound waves to create images of the heart, allowing doctors to see if the heart muscle is thickened and how well it pumps blood. This test can also show if blood flow is obstructed.
2. Electrocardiogram (ECG): An ECG records the electrical activity of the heart. It can reveal any irregular heart rhythms or other signs of HCM, such as changes in the heart’s electrical pattern due to the thickened muscle.
3. MRI of the Heart: In some cases, doctors may use an MRI scan for a more detailed look at the heart’s structure. A heart MRI can show the exact thickness and location of the thickened muscle, which helps in diagnosing HCM more accurately.
4. Genetic Testing: Since HCM is often genetic, doctors might recommend genetic testing, especially if there is a family history of the condition. Genetic testing can identify the specific mutation causing HCM, which helps in understanding family risk and deciding if family members should be screened for HCM.
5. Exercise Stress Test: Sometimes, doctors perform a stress test to see how the heart responds to physical activity. This can reveal symptoms and issues with blood flow that might not show up when the person is at rest.
By using these tests together, doctors can confirm an HCM diagnosis, understand the severity of the condition, and decide on the best treatment plan. Early diagnosis and regular check-ups can help people with HCM manage symptoms and reduce the risk of complications.
Conclusion
Hypertrophic Cardiomyopathy (HCM) is a condition that causes the heart muscle to thicken, making it harder for the heart to pump blood effectively. Though it can be challenging to manage, understanding HCM’s causes, types, symptoms, and treatment options can make a big difference in managing the condition. With the right combination of medical treatments and lifestyle changes, many people with HCM can lead active, fulfilling lives.
However, treating HCM can be expensive, especially when surgeries or implantable devices are needed. In India, the cost of HCM treatment can be overwhelming for many families. A crowdfunding platform can be a valuable tool for those needing financial assistance. By sharing their fundraising story on a crowdfunding platform, individuals can receive support from friends, family, and generous donors to help cover the costs of treatment, medical visits, and ongoing care, making it easier to focus on recovery and health.
