Hypertrophic Cardiomyopathy (Cardiomyopathy, Hypertrophic; HCM; Idiopathic Hypertrophic Subaortic Stenosis; Asymmetric Septal Hy

Risk FactorsThese factors increase your chance of developing this condition. Tell your doctor if you have any of these risk factors:Having a family member with HCMBeing over age 60 and having hypertension Symptoms Symptoms include: Chest painFainting, particularly during exerciseDizziness or lightheadedness, particularly following exerciseHeart palpitationsShortness of breath or difficulty breathingGeneral fatigueTiring easily during exercise or activityShortness of breath when lying downThese symptoms can be caused by some of the side effects of the condition, including arrhythmias (abnormal heartbeats). The blocked or reduced blood flow is usually the cause of symptoms like dizziness, fainting, and difficulty breathing. DiagnosisYour doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include the following: Echocardiographyuses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heartTransesophogeal echocardiogramimages of the heart are taken to detect abnormalities Heart monitora portable electrocardiogram (ECG) records continuous heart activity usually over a 24-72 hour period to determine regularity of the heartbeat Heart cathetera catheter is inserted into an artery in the groin area and threaded to the heart chambers An x-ray machine shows real-time images of your body as a dye is injected through the catheter. This allows angiograms (photos) to be taken of the blood vessels and the heart. Blood testsChest x-rayuses radiation to take a picture of structures inside the body, especially bones. TreatmentTreatment focuses on controlling symptoms and preventing complications. Talk with your doctor about the best treatment plan for you. Treatment options include:

MedicationsMedications may be used to help maintain proper and regular heart function. These may include beta-blockers and calcium channel blockers.If you have an arrhythmia, you may need anti-arrhythmic drugs. You may also need blood-thinning medication. SurgeryThe thickened portion of the heart muscle is cut and removed. This may be needed if you have a severely blocked blood flow from the heart.If the mitral valve is leaking, surgery may also be done to repair or replace the mitral valve. Alcohol Septal AblationAlcohol is injected into the arteries of the thickened portion of the heart. This helps to reduce the blockage in the heart and improve blood flow out of the heart. Implantable Cardioverter Defibrillators (ICD)This ICD is implanted if you are at heightened risk for sudden death. Prevention To help reduce your chance of getting HCM, take the following steps: If you have a family member who has been diagnosed with HCMyou and other family members should be screened for the conditionIf family history puts you at higher risk for HCMregular echocardiograms may reduce the risk of death or complications from HCMIf you have high blood pressuretake medications and follow other instructions as directed by your physician. RESOURCES:

American Heart Associationhttp://www.americanheart.org/presenter.jhtml?identifier=1200000 Cardiomyopathy Associationhttp://www.cardiomyopathy.org/index.php?id=1 CANADIAN RESOURCES: Canadian Cardiovascular Societyhttp://www.ccs.ca/home/index_e.aspx Heart and Stroke Foundation of Canadahttp://ww2.heartandstroke.ca/Page.asp?PageID=24 References: Cardiomyopathy. The American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4468 . Accessed June 26, 2007. Cardiomyopathy. EBSCO DynaMed website. Available at: http://dynamed102.ebscohost.com/Detail.aspx?id=115426 .Accessed June 26, 2007. Erwin JP, Nishimura RA, et al. Dual chamber pacing for patients with hypertrophic obstructive cardiomyopathy: a clinical perspective in 2000. Mayo Clin Proc. 2000;75:173-180. The HCM Program. St. Luke's Roosevelt Hospital Center website. Available at: http://www.hcmny.org/whatis/index.html . Accessed June 26, 2007. Hypertrophic cardiomyopathy. The Cleveland Clinic Heart and Vascular Institute website. Available at: http://www.clevelandclinic.org/heartcenter/pub/guide/disease/hcm/default.htm . Accessed June 26, 2007.

Hypertrophic cardiomyopathy. Medline Plus Medical Encyclopedia. US National Library of Medicine website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000192.htm .Accessed June 26, 2007. Maron BJ, Nishimura RA, McKenna WJ, et al. Assessment of permanent dual chamber pacing for patients with hypertrophic cardiomyopathy. Circulation . 1999;99:2927-2933. McCully RB, Nishimura RA, Tajik AJ, Schaff HV, Danielson GK. Extent of clinical improvement after surgical treatment of hypertrophic obstructive cardiomyopathy. Circulation . 1996;94:467-471. Last reviewed April 2008 by Michael J. Fucci, DOPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.