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  Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is a disease characterized by thickened myocardium, left ventricular stiffness, mitral valve changes and cellular changes. Thickening of the myocardium occurs at the septum below the aortic valve. This thickening may cause narrowing that can lead to reduction of blood flow from the left ventricle to the aorta. As a result, the ventricles have to pump much harder to overcome the narrowing. Hypertrophic cardiomyopathy is the most famous leading cause of sudden cardiac death in young athletes and in any other age group. Left ventricular hypertrophy is a probable finding for patients with hypertrophic cardiomyopathy. It involves the interventricular septum. Many patients with hyertrophic cardiomyopathy are asymptomatic. Shortness of breath, chest pain, uncomfortable awareness of the heart beat, lightheadedness, fatigue, fainting and sudden cardiac death are some of the symptoms if hypertrophic cardiomyopathy is symptomatic. Risk factors for developing sudden death include a young age at first diagnosis, an aborted sudden death, family history of hypertrophic cardiomyopathy with sudden death for relatives, supraventricular or ventricular tachycardia, recurrent syncope, and bradyarrhythmias.

Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy


Risk stratification is essential to ascertain which patients are at risk for sudden death. Medical therapy is successful for most of these patients. Beta-blockers are the first medicinces considered. Metoprolol, atenolol, bisoprolol, propanolol are just some of these drugs. If symptoms persist, disopyramide is added. Most patients’ symptoms may be managed medically; therefore, surgical septal myectomy and ablation are not advisable. However, if symptoms are not relieved by medications, surgical septal myectomy is the gold standard to relieve these symptoms. It decreases left ventricular outflow tract obstruction and improves symptoms. Pacemakers have been also used in some individuals.

Hypertrophic cardiomyopathy can be inherited and can be caused by an abnormality in the gene that codes the characteristics for heart muscle. It can also be acquired as a result of aging and high blood pressure.

Symptoms of hypertrophic cardiomyopathy may include chest pressure or pain. This usually occurs with physical activity or exercise. Shortness of breath and fatigue can also be experienced especially with exertion. Syncope may also be present. This is due to irregular heart rhythms or abnormal responses of blood vessels during exercise. Palpitations associated with hypertrophic cardiomyopathy are due to arrhythmias. Sudden death may also occur.

Diagnosis of hypertrophic cardiomyopathy is based with medical history, physical examination, and laboratory tests such as the echocardiogram. Echocardiogram is the most common test used to diagnose hypertrophic cardiomyopathy because thickening of the walls is readily visible on the echocardiogram. Other tests that may help include chest x-ray, electrocardiogram, magnetic resonance imaging, exercise stress test and blood tests.

Treatment is aimed to reduce complications and prevent symptoms. It usually involves regular followup, change in lifestyle, medications and procedures. The type of treatment, however, will depend on the presence of arrhythmias, age and activity level of patient, presenting symptoms, function of the heart, and if there is narrowing in the outflow tract from the heart.

Medications will be used to treat symptoms. They help relax the muscles of the heart and reduce the obstruction. As a result, the heart will pump more efficiently. Calcium channel blockers and beta-blockers are just some of the medications. If you will be taking medication, it is important to know the names of your medication and what are they for. You must also know how often you should take them. Certain medications will sometimes be avoided. Nitrates lower blood pressure. Digoxin increases the force of contraction of the heart.

Sodium restrictions may be necessary for some patients. This is necessary for patient with heart failure symptoms. Noncompetitive aerobic exercise may also help. However, it is still advisable to ask your doctor about your exercise.

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