What is hypertrophic cardiomyopathy?

Hypertrophic cardiomyopathy (HCM) is a condition that causes the heart muscle to become thicker than normal. The thickening most often affects the lower left chamber of the heart, called the left ventricle. When the muscle becomes too thick, it can make it harder for the heart to pump blood efficiently.

HCM is usually caused by inherited genetic changes that affect the heart muscle. A family history of the condition increases the risk. Because HCM can run in families, healthcare providers may recommend screening for close relatives. Some people have few symptoms, while others may develop breathing problems, chest discomfort, or changes in heart rhythm over time.

Symptoms

Symptoms of HCM vary from person to person. Some people may not notice symptoms for years, while others develop problems during exercise or daily activity.

Common symptoms may include:

• Shortness of breath
• Chest pain or pressure
• Fatigue or reduced energy
• Dizziness or lightheadedness
• Fainting or near fainting
• Rapid or irregular heartbeat
• Swelling in the legs, ankles, or feet

How is it diagnosed?

A healthcare provider will review your symptoms, medical history, and family history before performing a physical exam. If HCM is suspected, additional heart testing may be recommended.

Common diagnostic tests include:

• Electrocardiogram (ECG) to evaluate heart rhythm
• Echocardiogram to view heart structure and blood flow
• Cardiac MRI for detailed heart images
• Exercise or stress testing
• Portable heart monitors to track abnormal rhythms
• Genetic testing in some cases

These tests help providers understand how the heart is functioning and determine the best treatment approach.

How is it treated?

Treatment for HCM depends on your symptoms, overall health, and how much the condition affects blood flow through the heart. Many people manage symptoms successfully with medications and routine follow-up care.

Treatment options may include:

• Limiting intense physical activity when recommended
• Staying well hydrated
• Medications to relax the heart and improve blood flow
• Medicines to control abnormal heart rhythms
• Blood thinners for patients with certain rhythm conditions

If symptoms become severe or blood flow is significantly blocked, more advanced treatments may be considered. These can include procedures to reduce thickened heart muscle or implantation of a device called an implantable cardioverter defibrillator (ICD) to help protect against dangerous heart rhythms.

Regular monitoring is important, even if symptoms are mild.