Hypertrophic Cardiomyopathy (HCM) - CHI Health, Omaha, Nebraska (NE)

Hypertrophic Cardiomyopathy (HCM) is a genetic condition that affects the septum or the muscle of the heart that divides the left and right ventricle. The septum becomes abnormally thickened and restricts the blood flow from the left ventricle. Another non-genetic cause of HCM is uncontrolled high blood pressure. High blood pressure causes the heart to work harder which then leads to thickening of the muscle.

What are the symptoms?

Most patients have no symptoms related to HOCM.  However, the first sign of the condition can be sudden collapse and possible death.  The collapse and sudden death can be caused by irregular, abnormal heart rhythms or from lack of blood flow to the rest of the body. Other symptoms that may be present are chest pain, dizziness, lightheadedness, shortness of breath, heart palpitations or skipped beats, fainting or feeling tired.

What tests does HVI perform?

Patients can wear a Holter monitor or heart rhythm monitor to detect the irregular, abnormal heart rhythms. Most patients with HOCM have a heart murmur. An echocardiogram or ultrasound of the heart can be done to check on the thickness of the septum as well as to look at the heart valve function and find the cause of the heart murmur. An MRI of the heart can also be performed to look at the thickness of the septum as well.  A cardiac catheterization can be done to check for blockages in the heart arteries as well as pressures within the heart.

How does HVI treat this condition?

Treatment of HOCM includes using beta-blocker or calcium channel blocker medications to control blood pressure and help the heart relax so it can pump blood more effectively. Sometimes an internal cardioverter defibrillator (ICD) needs to be implanted to prevent sudden death due to the irregular heart rhythms. If the muscle is too thick and doesn’t allow blood flow out of the heart, a procedure called a surgical myectomy can be performed to remove a portion of the thickened muscle. Another procedure called an alcohol septal ablation can be done to decrease the thickening as well. Alcohol can be injected into certain arteries of the heart causing that portion of the muscle to die and allows the blood to flow out of the heart more easily.

What is the prognosis for the patient with this condition?

Sudden death due to hypertrophic cardiomyopathy is the leading cause of death in young people under the age of 35. It is commonly seen in athletes, but can effect non-athletic people as well. Sudden death usually occurs during physical activity. Those patients who are asymptomatic and who receive appropriate treatment will have a normal lifespan. Some patients may have shorter lifespan if they develop more symptoms.