What is hypertrophic cardiomyopathy?
Hypertrophic cardiomyopathy is primarily a disease of the heart muscle characterized by increased wall thickness due to causes internal to the muscle itself. This thickening of the heart wall is known as hypertrophy.
This thickening can make it difficult for the heart to pump blood.
Prognosis of hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy is a serious disease that can cause very serious complications. Some of them are:
- Atrial fibrillation: the thickening alters the structure and normal functioning of the heart’s electrical system, speeding up the heartbeat, as well as increasing the risk of suffering a clot.
- Sudden cardiac death: ventricular tachycardia and ventricular fibrillation can cause sudden death. Although it is not very frequent, people with hypertrophic cardiomyopathy are at greater risk of suffering it. It is more common for this sudden death to occur in people under 30 years of age.
- Blood flow obstructions: the thickening of the heart obstructs the blood flow from the heart to the rest of the body, which can cause shortness of breath, chest pain, fainting, dizziness, etc.
- Dilated cardiomyopathy: the heart gradually weakens, enlarging the ventricle, which loses pumping capacity.
- Mitral valve problems: blood may leak in the wrong direction, worsening symptoms as mitral valve insufficiency occurs.
- Heart failure: As the heart thickens, it may not be efficient enough to pump the blood needed for the entire body.
Symptoms of hypertrophic cardiomyopathy
The symptomatology of hypertrophic cardiomyopathy includes the following symptoms:
- Shortness of breath during physical activities.
- Chest pain, especially during exercise.
- Fainting; during or just after exercise
- Sensation that the heart is beating too fast
- Heart murmur
Medical tests for hypertrophic cardiomyopathy
When diagnosing the disease, a number of medical tests may be done:
- Echocardiogram
- Electrocardiogram
- Stress test
- Holter monitor
- Magnetic resonance imaging
- Cardiac catheterization
- Genetic testing
Cardiomyopathy often goes undiagnosed because those who have it have hardly any symptoms and can lead a completely normal life.
What are the causes of hypertrophic cardiomyopathy?
Most hypertrophic cardiomyopathies are caused by genetic mutations that thicken the heart muscle. This disease cannot be attributed to a specific cause, although in most cases it is hereditary.
Patients with cardiomyopathy also have an abnormal arrangement of heart cells that can cause arrhythmia.
The severity of the disease varies, with the most common type enlarging the heart and limiting blood flow out of the myocardium.
Occasionally, the flow is barely blocked, although pumping capacity is lost.
Can hypertrophic cardiomyopathy be prevented?
As mentioned above, the main cause of hypertrophic cardiomyopathy is heredity, so there is no way to prevent the disease, although early diagnosis is important to avoid complications.
Above all, prevention of sudden death is important. It has been shown that a defibrillator can stop and prevent sudden death due to heart attack.
However, as many people are unaware that they have the disease, sudden death due to heart attack is the first symptom, appearing in apparently healthy and young people.
Thus, as a preventive measure, patients are also usually advised not to engage in most competitive sports, in order to avoid problems of sudden death.
Treatments for hypertrophic cardiomyopathy
The goal of treatment is to alleviate symptomatology as well as prevent sudden death from heart attack. Some options for doing so are:
- Medications: medications relax the muscle and slow its heart rate, pumping blood efficiently.
- Myectomy of the septum: this is an open heart procedure in which a part of the thickened septum that separates the ventricles is removed, improving the flow and reducing the insufficiency of the mitral valve.
- Septal ablation: a part of the thickened heart is destroyed through the injection of alcohol by catheter.
- Implantable cardioverter defibrillator: this is recommended for people with arrhythmias. It is a small device that controls the heartbeat and is implanted in the chest like a pacemaker. In the event of an arrhythmia, the defibrillator delivers electric shocks to restore the heart rhythm.
Which specialist treats hypertrophic cardiomyopathy?
The specialists in charge of treating and diagnosing the disease and problems derived from hypertrophic cardiomyopathy are Cardiologists, both adult and pediatric, as well as Cardiac Surgeons.