Hypertrophic cardiomyopathy (HCM) is a disease that creates an abnormal thickness of the heart muscle, making it harder for the heart to pump blood. HCM is the most common form of genetic heart disease, affecting about 1 in 500 people.
While some with HCM have no symptoms, the disease can lead to life-threatening complications such as heart failure if left untreated or undiagnosed. This post will explore:
- Causes of HCM
- Symptoms and treatment options
- The importance of mental health care and a support system for HCM patients
What Is Hypertrophic Cardiomyopathy?
HCM is one of four main types of cardiomyopathy, a disease that affects the heart muscle. With HCM, the muscle of the hearts walls thickens, restricting the amount of space inside the heart for blood to be pumped out.
The two main types of HCM are:
- Obstructive HCM. This happens when the wall between the two bottom chambers of the heart (the septum) blocks or reduces the blood flow from the left ventricle to the aorta, according to the American Heart Association (AHA).
- Nonobstructive HCM. In nonobstructive HCM, the heart muscle is thickened but doesnt block blood flow out of the heart. (AHA)
Causes of Hypertrophic Cardiomyopathy
Genetics is the primary cause of HCM. If a parent has HCM, its about 50% more likely their child will also have the condition. Its important to know your family history since HCM has a genetic link. If you can report that a close relative had HCM, your provider will be more likely to screen you and catch it earlier.
Genetics isnt the whole picture, though. One study found about 40% of people with HCM have a subtype called nonfamilial HCM, meaning they dont have a family history of the disease.
The study showed that people with this type of HCM tend to develop the disease later in life and have a milder form. They also have better survival rates without major heart problems.
This form of HCM is most often triggered by non-genetic conditions, such as:
- Aging
- Uncontrolled high blood pressure
- Medical conditions such as diabetes and thyroid disorders, which can lead to thickening of the heart muscle
- Certain drugs, such as anabolic steroids
- Some viral or bacterial infections that trigger inflammation (though this is rare)
Symptoms of Hypertrophic Cardiomyopathy
Many people who have HCM have no symptoms. When symptoms do appear, HCM patients are often incorrectly diagnosed because HCM symptoms can be similar to other conditions. Common misdiagnoses for HCM patients include asthma, mitral valve prolapse, and even anxiety, panic attacks or depression.
Common HCM symptoms include:
- Shortness of breath
- Fatigue
- Chest pain
- Fainting
- A heart murmur
- Swelling in the legs, feet or abdomen
- A fluttering heartbeat
If youre experiencing any of these symptoms, consult your doctor immediately.
Diagnosis and Treatment of Hypertrophic Cardiomyopathy
Your provider will diagnose the condition based on your family medical history and a physical exam that includes listening to your heart. If a swishing or whooshing sound is audible through the stethoscope, it could indicate HCM. The next step is to order one or more tests to diagnose HCM or rule out conditions with similar symptoms. Tests may include an echocardiogram, electrocardiogram (EKG), cardiac MRI or a stress test.
Once youve received an HCM diagnosis, your treatment plan will vary depending on factors like how severe your symptoms are and the presence of any underlying health conditions.
Treatment options include:
Medication. Right now, theres only one medication specific to treating HCM. It works by decreasing the force of the hearts contractions. It is most commonly used in patients with obstructive HCM who are experiencing symptoms.
Your provider may also recommend other medications such as beta-blockers, calcium channel blockers and diuretics to help control heart rate, reduce chest pain and decrease fluid buildup. These medications can help relieve symptoms and enhance the quality of life for HCM patients.
Surgical and nonsurgical procedures. Sometimes, surgery is needed to reduce the blockage. In some cases, this can be done with a non-surgical procedure called an alcohol septal ablation. In severe cases, HCM patients may need a heart transplant.
Devices. A cardiac implantable electronic device (CIED) like a pacemaker or ICD might be needed to keep your heart in normal rhythm. A left ventricular assist device (LVAD) may be needed before transplant.
Lifestyle changes. Your care team may recommend lifestyle changes that include a heart-healthy diet, certain types of exercise, controlling blood pressure and reducing stress to help keep your heart healthy for longer.
HCM and Your Mental Health
Living with HCM is more than just a physical journey. The reality of living every day with a chronic illness can take an emotional and psychological toll. In fact, having a chronic illness can put you at greater risk of developing mental health conditions.
This is why mental health care should always be part of your care plan. Talk to your provider right away if youre feeling overwhelmed, anxious, depressed or exhibiting signs of depression. Talk therapy, stress management techniques or even medication to help ease your mind.
A Note About Exercise and HCM
Exercise is known to be a significant contributor to both physical and mental well-being. But for many years, HCM patients were advised against vigorous exercise, including participation in competitive sports, because it was thought to increase the risk of sudden cardiac death (SCD). Recent studies have challenged that thinking, causing experts to rethink the guidelines on HCM and exercise, putting more emphasis on shared decision-making among patients and their providers when it comes to exercise. In collaboration with your provider, moderate exercise can indeed be good for your physical and mental health.
Finding a Support Network
Your network of family and friends can offer advice, emotional support and a sense of belonging. They can also help you live better and longer. A strong social support network has been linked to higher survival rates in patients with heart disease.
Peer support falls into this category as well. Being in regular communication with people who face similar challenges can help lessen the feelings of isolation and offer hope from someone who understands exactly what youre going through.
Whether your support comes from home, work, school or an organization like Mended Hearts, you dont have to go it alone. Building a support network is one of the best things you can do for your mental and physical health as you navigate life with HCM.
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