Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy is a condition in which the heart muscles become too thick, due to changes in the heart muscle proteins. This change in heart size makes it hard to pump blood properly throughout the body. This is a serious condition and has been known to cause sudden death, during exercise.

SYMPTOMS

  • Chest pain.

  • Abnormal heart rhythms.

  • Fainting (syncope).

  • Rapid heart rate, felt in the chest (palpitations).

  • Death, without warning.

  • Poor tolerance for exercise.

  • Difficulty breathing (dyspnea).

  • Fluid build up (edema) in the feet and ankles.

CAUSES

The way this disease occurs is not well understood. It is believed to be caused by gene mutations, which affect the heart's ability to pump blood. The body responds to the lack of pumping by making the heart muscle bigger. However, a larger heart is actually less able to pump blood through the body, including through the vessels of the heart itself. The heart muscle becomes thick and stiff. Eventually, the heart does not receive enough oxygen and the heart begins to fail, which can cause sudden death.

RISK INCREASES WITH:

  • Family history of the disease or of sudden death from unexplained causes.

  • Unexplained fainting (syncope).

PREVENTION

  • Medicines to decrease the work of the heart, such as beta-blockers.

  • Eliminating intense exercise.

  • Genetic counseling regarding family and activity.

PROGNOSIS

This is a serious medical condition. People with the disease are advised to stop all physical activities, except those that are very easy.

RELATED COMPLICATIONS

People with this condition have an increased risk for developing abnormal heart rhythms and heart valve infections. The most serious complication is sudden death.

TREATMENT

  • In most cases, athletes are told to stop intense training and high levels of competition. For some athletes, stopping athletics causes distress, and counseling may be needed.

  • Medicines, such as beta-blockers, may be given to decrease the work of the heart. These medicines may not be tolerated well.

  • Since the condition is inherited, family members of the affected individual may also be screened.

  • People who work with or are close to the patient should learn CPR, since cardiac arrest is a possible complication of the disease.

  • Athletes should be closely monitored by their caregiver. Tests should be repeated frequently, to observe the progression of the disease.

  • Surgery may be advised, to reduce obstructions to blood flow in the heart, or to replace failing heart valves.

  • Use of a medical alert bracelet is advised.

MEDICATION

  • Beta-blockers and calcium channel blockers are generally the first attempted medicines. These drugs can reduce the work of the heart and reduce abnormal rhythms.

  • Nitroglycerin is a medicine often given to people with hypertension. However, it should be avoided in patients with hypertrophic cardiomyopathy.

ACTIVITY

  • Athletic participation should be stopped until a caregiver is able to asses the severity of the disease.

  • Activity is possible, if performed within safe guidelines as recommended by your caregiver. Athletes should not regard themselves as incapable of all activity.

DIET

A low sodium diet is advised, if symptoms of heart failure (heart is unable to pump out blood) develop. Otherwise, no special diet is advised.

SEEK MEDICAL CARE IF:

  • You have an episode of fainting, especially if related to exercise.

  • A close relative is diagnosed with hypertrophic cardiomyopathy.

  • There is a change in your exercise tolerance.

  • You develop a rapid or irregular heartbeat, shortness of breath, chest pain, or increased difficulty breathing.

  • Medicines prescribed for this condition produce intolerable side effects.