What is hypertrophic cardiomyopathy?
Hypertrophic cardiomyopathy is primarily a disease of the heart muscle characterised by increased wall thickness due to internal causes of the muscle itself. This thickening of the heart wall is known as hypertrophy, which can make it difficult for the heart to pump blood.
Prognosis of hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy is a disease that can cause very serious complications. Some of these are:
- Atrial fibrillation: the thickening alters the structure and normal functioning of the heart's electrical system, speeding up the heartbeat and increasing the risk of a clot
- Sudden cardiac death: Ventricular tachycardia and ventricular fibrillation can cause sudden death. Although it is not very common, people with hypertrophic cardiomyopathy are at greater risk. Sudden death is more common in people under the age of 30
- Obstructions in blood flow: the thickening of the heart obstructs the blood flow from the heart to the rest of the body, which can cause shortness of breath, chest pain, fainting and dizziness
- Dilated cardiomyopathy: the heart gradually weakens, the ventricle enlarges and loses pumping capacity
- Mitral valve problems: blood may flow in the wrong direction, with symptoms worsening if the mitral valve fails to close properly
- Heart failure: when the heart thickens, it may not be effective enough to pump the blood needed for the entire body.
Symptoms of hypertrophic cardiomyopathy
The symptoms of hypertrophic cardiomyopathy include the following:
- Shortness of breath with physical activity
- Chest pain, especially when exercising
- Fainting during exercise or just after exercise
- Feeling that the heart is beating too fast
- Heart murmur.
Medical tests for hypertrophic cardiomyopathy
A series of medical tests can be performed to help diagnose the disease:
Cardiomyopathy often goes undiagnosed because there are very few symptoms.
What are the causes of hypertrophic cardiomyopathy?
Most hypertrophic cardiomyopathies are caused by genetic mutations that thicken the heart muscle. The disease cannot be attributed to a specific cause, although in a large number of cases it is hereditary.
Individuals with cardiomyopathy also have an abnormal arrangement of heart muscle cells which can cause arrhythmia.
The severity of the disease varies, but it most commonly enlarges the heart and limits blood flow out of the myocardium.
Sometimes the flow is only slightly blocked, but the heart has lost its pumping capacity.
Can hypertrophic cardiomyopathy be prevented?
As mentioned above, the main cause of hypertrophic cardiomyopathy is heredity, so there is no way to prevent the disease, although early diagnosis is important to avoid complications.
The prevention of sudden death is especially important. It has been shown that a defibrillator can stop and prevent a sudden death from heart attack.
However, since many people are not aware that they have the disease, sudden death from a heart attack may be the only sign that they have the disease, and it can occur in apparently healthy, young people.
As a preventive measure, people with the disease are often advised to avoid playing certain competitive sports in order to avoid sudden death.
Treatments for hypertrophic cardiomyopathy
The aim of treatment is to relieve symptoms as well as to prevent sudden death from a heart attack. Ways of doing this include:
- Drugs: some drugs relax the heart muscle and slow the heart rate, helping it to pump blood efficiently
- Septal myectomy: this is an open-heart procedure in which part of the thickened septum that separates the ventricles is removed, thus improving flow and reducing mitral valve insufficiency
- Alcohol septal ablation: this involves injecting pure alcohol into part of the enlarged heart through a catheter, causing some of the muscle to shrink and die
- Implantable cardioverter defibrillator: recommended for people with arrhythmias. It is a small device that controls the heartbeat and is implanted in the chest as though it were a pacemaker. In the event of an arrhythmia, the defibrillator delivers electric shocks to restore the heart rhythm.
Which specialist treats hypertrophic cardiomyopathy?
The specialists in charge of treating and diagnosing hypertrophic cardiomyopathy and associated problems are cardiologists and cardiac surgeons.