What is hypertrophic cardiomyopathy?
Hypertrophic cardiomyopathy, or HCM, is a condition where the heart muscle becomes abnormally thick. As a result, the heart becomes inefficient and has to work harder to pump blood. This extra work can cause symptoms such as fatigue and shortness of breath, and potentially serious complications. Most people, though, can live normally with hypertrophic cardiomyopathy.
Types of hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy can affect the heart in several ways. In many cases, it causes thickening of the septum, a wall of tissue that divides your heart into two sides. Thickening of the septum between the ventricles (your heart’s lower chambers) can interfere with blood flow out of the heart.
Less commonly, HCM can cause thickening in other parts of the heart muscle, which can have many effects on your body. These effects include reducing the left ventricle’s ability to fill with blood and causing the mitral valve to leak.
Doctors classify hypertrophic cardiomyopathy into types based on where thickening of the tissue occurs and whether it disrupts blood flow. Types of this condition include:
- Obstructive hypertrophic cardiomyopathy: This is the most common type. Thickening of the septum blocks or reduces blood flow into the aorta, the body’s largest artery.
- Nonobstructive hypertrophic cardiomyopathy: The heart muscle thickens, but blood can still flow normally.
- Apical hypertrophic cardiomyopathy: This subtype of nonobstructive hypertrophic cardiomyopathy affects the apex, or bottom, of the heart.
Hypertrophic cardiomyopathy symptoms
Hypertrophic cardiomyopathy may not cause symptoms, at least at first. Some people notice symptoms only when they’re exercising or exerting themselves. The condition is chronic, which means it gradually worsens, so you may notice symptoms that develop over time.
Hypertrophic cardiomyopathy symptoms include:
- Arrhythmia (or fast and irregular heartbeats)
- Chest pain
- Dizziness
- Fainting
- Lightheadedness
- Loss of energy
- Shortness of breath
- Swelling in your stomach, legs, ankles, feet or neck veins
When to see a doctor
See your primary care doctor if you experience symptoms of hypertrophic cardiomyopathy. If they suspect thickening of the heart muscle, they may refer you to a heart and vascular specialist.
Hypertrophic cardiomyopathy causes
In most cases, HCM develops due to genetic mutations that affect the way the heart muscle grows. A mutation in just one copy of a gene can be enough to cause thickening of the tissue.
Hypertrophic cardiomyopathy risk factors
Hypertrophic cardiomyopathy affects people of all ages and can develop at any time in life. Due to its genetic roots, the condition often runs in families, so if a parent was diagnosed with HCM, you have a higher risk of developing it. If you have a parent or sibling with the condition, you should talk to your doctor about your risk.
Aside from genetics, doctors have identified a few other risk factors for hypertrophic cardiomyopathy, such as high blood pressure.
Complications
Most people with hypertrophic cardiomyopathy don’t develop complications. In some cases, serious heart problems can occur, especially as the condition progresses. In young people and athletes, HCM is a common cause of sudden cardiac death, but this is very rare.
Complications of hypertrophic cardiomyopathy can include:
- Atrial fibrillation: Thickening of the heart muscle can cause the atria (top chambers of the heart) to stretch, beat rapidly and irregularly and cause potentially dangerous blood clots.
- Heart failure: As the heart thickens and stiffens, it may struggle to fill with and pump enough blood.
- Stroke: Blood clots caused by atrial fibrillation can travel to the brain and cause a stroke.
- Sudden cardiac death: If the heart beats too fast, it may suddenly stop, a condition called sudden cardiac arrest that can cause death.
- Ventricular tachycardia/fibrillation: Another potentially dangerous arrhythmia, ventricular tachycardia is when your ventricles beat rapidly.
Diagnosing hypertrophic cardiomyopathy
Your doctor will ask about your personal and family medical history and your symptoms. They will also conduct a physical exam to check for signs of thickening of the heart muscle.
With hypertrophic cardiomyopathy, a heart murmur is often a telltale sign that something is wrong. Your doctor will listen to your heart and check for murmurs and possibly order tests to look for evidence of thickening, stiffness or obstruction.
-
Medical history and exam
Your doctor will ask about any medical conditions you have, especially heart problems. They will also want to know whether you have a family history of hypertrophic cardiomyopathy or other heart conditions, such as arrhythmia, heart failure, stroke or heart attack.
Your doctor will ask about your symptoms. Be sure to tell your doctor when the symptoms started, what they feel like, how often they occur and how they affect your ability to perform daily activities.
Next, your doctor will examine you to check your physical condition and look for signs of hypertrophic cardiomyopathy. They will listen to your heart and lungs to detect issues, such as a heart murmur, that may indicate hypertrophic cardiomyopathy.
-
Imaging
Common imaging to diagnose hypertrophic cardiomyopathy include:
- Echocardiogram: This test uses ultrasound waves to create images evaluating the heart muscle, its thickness, its function and the valves.
- Cardiac CT scan: This imaging test can create a 3D image of your heart that allows your doctor to look for narrowed arteries and better understand how well the heart is working.
- Cardiac MRI scan: This test uses strong magnets and radio waves to produce images that can show how well the heart is working. These images allow doctors to look for problems with blood flow, left ventricular pumping and valve function.
- Chest X-ray: A chest X-ray can show enlargement of the heart that may indicate hypertrophic cardiomyopathy.
-
Testing for HCM
Several tests can also help your doctor diagnose hypertrophic cardiomyopathy or rule out other conditions that may be causing your symptoms. These tests include:
- Electrocardiogram (EKG): EKGs measure electrical activity in your heart. The test can help detect arrhythmias and other problems caused by thickening of the heart muscle.
- Echocardiogram: One of the most common tests for diagnosing hypertrophic cardiomyopathy, an echocardiogram uses sound waves to form images of the heart. This test can show thickening of the heart tissue.
- Exercise stress test: An exercise stress test can show how efficiently your heart pumps. You’ll walk on a treadmill or ride a stationary bike while medical professionals monitor your heart rate, rhythm and electrical activity.
- Heart monitors: These portable devices record your heart’s activity for a few days to a few weeks. The data can show whether you experienced any arrhythmias while wearing it.
Hypertrophic cardiomyopathy treatment
Your doctor will determine how best to treat hypertrophic cardiomyopathy based on the type you have, how well your heart is working and whether you have any symptoms, among other factors. Treatment cannot cure the condition, but it can reduce symptoms and lower your risk for complications.
Your doctor will likely recommend changing your lifestyle to improve your heart health. They may prescribe medications to lower the heart rate and treat symptoms by helping your heart work better. If you have severe symptoms or lifestyle changes and medications haven’t helped, you may need surgery to address the condition and protect against complications.
Lifestyle changes
Lifestyle changes can help protect your heart and reduce the risk of heart problems that hypertrophic cardiomyopathy can cause. Your doctor may suggest the following:
- Be moderately active: Exercise is good for your heart, but talk to your doctor about which activities are right for you, especially if you’re an athlete.
- Maintain adequate hydration: Drinking too much fluid or not having enough fluid can cause the heart to function poorly, leading to feelings of lightheadedness or leg swelling.
- Manage chronic health conditions: If you have heart failure, high blood pressure, sleep apnea or another long-term health problem, ensure you manage it appropriately to reduce the risk of complications.
- See your doctor regularly: They will monitor you for new or worsening symptoms. They will also want to assess how well your treatment is working.
Medication
Several medications can help you manage symptoms and improve heart function by slowing down the heart rate, including:
- Beta blockers: These medications can improve the heart’s pumping ability. They can also treat certain arrhythmias by slowing your heart rate.
- Calcium channel blockers: These medications relax the heart muscle and can help your heart pump more efficiently.
- Diuretics: These medications can reduce the strain on your heart by helping your body flush out excess fluids and potassium–but only if you have too much fluid in your body.
- Mavacamten: This medication can reduce strain on the heart and improve its function in people with symptomatic hypertrophic cardiomyopathy. It targets myosin, a protein involved in muscle contraction. Careful monitoring of the heart’s function is required for this medication.
Heart procedures
Surgery and other procedures can treat hypertrophic cardiomyopathy that causes severe symptoms or has become very advanced. Your doctor can help you decide if surgery is right for you. If you decide to proceed, your options may include:
- Alcohol septal ablation: This is a nonsurgical procedure in which your interventional cardiologist injects ethanol, a type of alcohol, into an artery that sends blood to a damaged area of heart muscle. The ethanol reduces the thickened tissue.
- Implantable devices: You may need a pacemaker, an implantable cardioverter defibrillator or a cardiac resynchronization therapy device to stop arrhythmias or improve heart function.
- Septal myectomy: A surgeon will remove a portion of the thickened septum to improve blood flow in the heart.
- Heart transplant: If your heart is severely damaged, you may need a donor heart to replace it.
Locations to treat hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy requires lifelong monitoring and management. Our heart teams in North and Central Texas can offer the comprehensive care you need to live a full life. We can help arrange care at the location best suited to your needs.
AccentCare - Fort Worth
3880 Hulen St , Fort Worth, TX, 76107
AccentCare Home Health of Brenham
526 W Main St , Brenham, TX, 77833
AccentCare Home Health of College Station
119 Medical Park Lane Ste C, Huntsville, TX, 77340
AccentCare Home Health of College Station
1605 Rock Prairie Rd Ste 206, College Station, TX, 77845
AccentCare Home Health Of Denton
225 W. Mulberry St. Ste A, Denton, TX, 76201
AccentCare Home Health Of Desoto
911 York Drive Ste 203, DeSoto, TX, 75115
AccentCare Home Health Of Fort Worth (Arlington)
700 Highlander Blvd Ste 205, Arlington, TX, 76015
AccentCare Home Health of Huntsville
122 Medical Park Lane B , Huntsville, TX, 77340
AccentCare Home Health of Marble Falls
1100 Mission Hills Dr Ste 100, Marble Falls, TX, 78654
AccentCare Home Health Of McKinney
6800 Weiskopf Ave Ste 100, McKinney, TX, 75070
AccentCare Home Health Of Taylor (Hutto)
567 Chris Kelley Blvd Ste 201, Hutto, TX, 78634
AccentCare Home Health Of Temple
3809 S General Bruce Dr Ste 105B, Temple, TX, 76502
AccentCare Home Health Of Waco
8300 Central Park Dr Ste A, Waco, TX, 76712
AdventHealth Central Texas
2201 S Clear Creek Rd , Killeen, TX, 76549
Andrews Women's Hospital at Baylor Scott & White - Fort Worth
1400 8th Ave , Fort Worth, TX, 76104
Baylor Scott & White - Hillcrest Infectious Disease Clinic
50 Hillcrest Medical Blvd MOB1, Ste 104, Waco, TX, 76712
Baylor Scott & White - Plano Brain and Spine Center
4708 Alliance Blvd Pavilion I, Ste 810, Plano, TX, 75093
Baylor Scott & White - Texas Brain and Spine Institute
900 Scott and White Dr , College Station, TX, 77845
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White - Texas Brain and Spine Institute - Huntsville
122 Medical Park Ln Ste A, Huntsville, TX, 77340
Baylor Scott & White - The Brenham Clinic
600 N Park St , Brenham, TX, 77833
- Monday: 7:30 am - 5:00 pm
- Tuesday: 7:30 am - 5:00 pm
- Wednesday: 7:30 am - 5:00 pm
- Thursday: 7:30 am - 5:00 pm
- Friday: 7:30 am - 5:00 pm
Baylor Scott & White 65+ Clinic
4716 Alliance Blvd Ste 500, Plano, TX, 75093
- Monday: 8:00 am - 4:30 pm
- Tuesday: 8:00 am - 4:30 pm
- Wednesday: 8:00 am - 4:30 pm
- Thursday: 8:00 am - 4:30 pm
- Friday: 8:00 am - 4:30 pm
Baylor Scott & White Advanced Cardiac Imaging Specialists
1100 Allied Dr , Plano, TX, 75093
Baylor Scott & White Advanced Cardiovascular and Imaging Consultants
4708 Alliance Blvd Ste 450, Plano, TX, 75093
Baylor Scott & White Advanced Digestive Care
3434 Swiss Ave Ste 200, Dallas, TX, 75204
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Advanced Heart and Lung Disease Center - Fort Worth
1420 8th Ave Ste 103, Fort Worth, TX, 76104
Baylor Scott & White Advanced Heart Care - Anna
450 N Standridge Blvd , Anna, TX, 75409
Baylor Scott & White Advanced Heart Care - Decatur
2401 S FM 51 Ste 200, Decatur, TX, 76234
Baylor Scott & White Advanced Heart Care - Denton
3333 Colorado Blvd , Denton, TX, 76210
Baylor Scott & White Advanced Heart Care - Idabel, OK
4 SE Avenue A , Idabel, OK, 74745
Baylor Scott & White Advanced Heart Care - Keller (Satellite)
3124 N Tarrant Pkwy Ste 204, Keller, TX, 76177
Baylor Scott & White Advanced Heart Care - McKinney (Satellite)
5236 W University Dr Ste 4450, McKinney, TX, 75071
Baylor Scott & White Advanced Heart Care - Mt Pleasant (Satellite)
1011 N Jefferson Ave , Mt Pleasant, TX, 75455
Baylor Scott & White Advanced Heart Care - Paris
875 S Collegiate Dr , Paris, TX, 75462
Baylor Scott & White Advanced Heart Care - Plano
4716 Dexter Dr Ste 100, Plano, TX, 75093
Baylor Scott & White Advanced Heart Care - Sherman Sycamore (Satellite)
203 E Sycamore St , Sherman, TX, 75090
Baylor Scott & White Advanced Heart Care - Sulphur Springs
601 Airport Rd Ste 110, Sulphur Springs, TX, 75482
Baylor Scott & White Advanced Heart Care – Sherman Highland (Satellite)
300 N Highland Ave , Sherman, TX, 75092
Baylor Scott & White Advanced Heart Failure Clinic - Irving
2001 N MacArthur Blvd Bldg 1, Ste 360, Irving, TX, 75061
Baylor Scott & White Advanced Heart Failure Clinic - Abilene
1219 E South 11th St Ste B2, Abilene, TX, 79602
Baylor Scott & White Advanced Heart Failure Clinic - Amarillo
1901 Medi Park Dr Ste 2051, Amarillo, TX, 79106
Baylor Scott & White Advanced Heart Failure Clinic - Dallas
3410 Worth St Ste 250, Dallas, TX, 75246
- Monday: 8:00 am - 4:30 pm
- Tuesday: 8:00 am - 4:30 pm
- Wednesday: 8:00 am - 4:30 pm
- Thursday: 8:00 am - 4:30 pm
- Friday: 8:00 am - 4:30 pm
Baylor Scott & White Advanced Heart Failure Clinic - Longview
906 Judson Rd , Longview, TX, 75601
Baylor Scott & White Advanced Heart Failure Clinic - Lubbock
3711 22nd St Ste B, Lubbock, TX, 79410
Baylor Scott & White Advanced Heart Failure Clinic - Midland/Odessa
420 E 6th St Ste 102, Odessa, TX, 79761
Baylor Scott & White Advanced Heart Failure Clinic - Tyler
1321 S Beckham Ave , Tyler, TX, 75701
Baylor Scott & White Advanced Heart Failure Clinic - Waxahachie
2360 N Interstate 35E MOB 2, Ste 310, Waxahachie, TX, 75165
Baylor Scott & White Advanced Heart Failure Specialists - Fort Worth
1250 8th Ave Ste 200, Fort Worth, TX, 76104
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Advanced Lung Disease Specialists - Dallas
3410 Worth St Ste 250, Dallas, TX, 75246
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 5:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 4:30 pm
Baylor Scott & White All Saints Medical Center - Fort Worth
1400 8th Ave , Fort Worth, TX, 76104
Baylor Scott & White Ambulatory Endoscopy Center
4708 Alliance Blvd Pavilion I, Ste 210, Plano, TX, 75093
- Monday: 7:00 am - 3:00 pm
- Tuesday: 7:00 am - 3:00 pm
- Wednesday: 7:00 am - 3:00 pm
- Thursday: 7:00 am - 3:00 pm
- Friday: 7:00 am - 3:00 pm
Frequently asked questions
-
Can people with hypertrophic cardiomyopathy exercise?
Yes, people with hypertrophic cardiomyopathy can exercise. Your doctor may recommend participating in light or moderate aerobic exercise instead of intense physical activity to reduce the risk of serious complications.
-
Is hypertrophic cardiomyopathy genetic?
Yes, in most cases, hypertrophic cardiomyopathy is genetic. You may inherit a gene mutation from a parent that causes the heart muscle to thicken.
-
Who is at risk for hypertrophic cardiomyopathy?
You have a higher risk for hypertrophic cardiomyopathy if at least one of your parents or siblings had the condition.
-
How common is hypertrophic cardiomyopathy?
Hypertrophic cardiomyopathy is the most common genetic heart condition in the US. It affects around 1 in 500 people.
-
What should you avoid with hypertrophic cardiomyopathy?
If you have HCM, your doctor may recommend avoiding vigorous physical activity due to the risk of sudden cardiac death. You should also avoid other heart-health risk factors, such as smoking, excessive alcohol consumption and foods high in sodium, sugar and unhealthy fats.
-
At what age does hypertrophic cardiomyopathy develop?
Hypertrophic cardiomyopathy can develop at any age. Most people with this condition are diagnosed during mid-life.
-
Will losing weight help with hypertrophic cardiomyopathy?
Reaching and maintaining a healthy weight benefits your heart health by allowing the heart to pump blood more easily and reducing the risk of cardiovascular problems.