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.
Doctor discussing hypertrophic cardiomyopathy with a patient

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.

visual of hypertrophic cardiomyopathy scans

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.

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.

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.

Frequently asked questions

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