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Hypertrophic Cardiomyopathy

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What Is Hypertrophic Cardiomyopathy (HCM)?

HCM is heart disease that causes the muscle fibers of the heart — mainly in the left ventricle — to thicken. It often affects the heart's ability to pump blood.

Hypertrophic cardiomyopathy (HCM) is the most common type of inherited heart disease in the U.S., affecting about 1 in 500 adults.

Types of hypertrophic cardiomyopathy (HCM)

The heart's left ventricle, or lower chamber, pumps blood filled with oxygen back into your body. The septum — a wall of tissue inside the heart — divides the heart's left and right lower chambers.

In HCM, the heart muscle in the septum or elsewhere in the heart's left side gets thick. This thickening might affect how blood flows, but sometimes it doesn't.

There are two types of HCM:

  • Obstructive: A thickened septum changes how blood flows or how the heart's mitral valve opens or closes.
  • Nonobstructive: The left side of the heart thickens, but blood flow doesn't change.

Hypertrophic cardiomyopathy (HCM) causes

People with HCM often inherit the condition, meaning their parents pass gene mutations on to them. This affects how these genes make proteins that tell the heart muscle how to grow and contract to pump blood.

If someone in your family has HCM, tell your doctor. You might need to have a screening test to see if you have it too.

Hypertrophic cardiomyopathy (HCM) risk factors and complications

You might be at risk for HCM if someone in your family has the condition. But some people are the first in their family to have it.

Many people with genetic HCM don't have symptoms. Or they're able to manage any symptoms they have.

But HCM can cause complications, such as:

  • Abnormal heart rhythms, or arrhythmia.
  • Heart failure.
  • Sudden death.

If you have HCM, it's crucial to routinely see your doctor to track your condition.

Why choose the Hypertrophic Cardiomyopathy Center for care?

The right HCM care helps you manage your disease and live a healthy life.

  • At the UPMC Hypertrophic Cardiomyopathy Center, we tailor your care to your unique needs.
  • We offer the newest treatments based on research. These include clinical trials of new HCM drugs and new imaging techniques that help doctors treat your disease.
  • We're western Pa.'s largest such center and one of the only to offer myectomy and alcohol septal ablation. These are procedures that treat the obstructive form of HCM.
  • The Hypertrophic Cardiomyopathy Association recognizes UPMC as a Center of Excellence.

Hypertrophic Cardiomyopathy (HCM) Symptoms and Diagnosis

People with inherited HCM don't always have symptoms.

But some people have:

  • Heart palpitations or fluttery heartbeats.
  • Dizziness or faint.
  • Chest pain.
  • Trouble breathing.

Sometimes, people die suddenly. HCM is the most common cause of sudden cardiac death in young people.

Diagnosing hypertrophic cardiomyopathy (HCM)

If your family has history of HCM or you feel symptoms, your doctor will screen you for the condition.

Doctors use different tests to diagnose HCM.

  • Echocardiogram: This test uses high-frequency sound waves to creates an image of your heart.
  • Electrocardiogram (EKG): Doctors place patches, on your skin. These patches connect through wires to a machine that measures your heart's electrical activity.
  • Holter monitor: This at-home EKG tracks your heart for 24 to 48 hours, capturing data about your heart is working.
  • Cardiac MRI: Doctors use a contrast agent, or special dye, and radio waves to look for scar tissue inside your heart.

Sometimes, doctors order genetic testing for people with a family history of HCM. Using a blood sample, doctors look for gene changes that cause the condition.

Hypertrophic Cardiomyopathy (HCM) Treatment

Your care team at UPMC will design a treatment plan that's right for you.

Goals of HCM care are to:

  • Improve your symptoms.
  • Reduce potential complications.
  • Educate patients and their families about how to live with HCM.

Doctors treat inherited HCM in several ways. 

Medicine to treat HCM

Doctors use drugs that help control blood flow and regulate heart beats to manage HCM symptoms.

These include:

  • Beta-blockers.
  • Calcium channel blockers.
  • Water pills.
  • Antiarrhythmics.

Surgery and procedures to treat hypertrophic cardiomyopathy (HCM)

Doctors sometimes suggest invasive procedures when HCM causes decreased blood flow.

These procedures include:

  • Myectomy: Open heart surgery to trim the thickened muscle and allow blood to flow freely.
  • Alcohol septal ablation: Using a catheter, or thin tube, doctors inject alcohol into a small artery that carries blood to the septum. Over time, the alcohol reduces the size of the muscle to allow blood to flow more freely.
  • Sometimes people who have HCM need a defibrillator. This is a small device placed in the chest to help regulate or stop dangerous heart beats.

UPMC is one of the only centers in the region that offers these surgeries to people with HCM.

Your physician may also discuss lifestyle changes that can help you manage your condition.