Hypertrophic Cardiomyopathy

Causes

The causes of the common forms of Hypertrophic cardiomyopathy include:

• Hypertrophic Cardiomyopathy may be inherited, caused by an abnormality in the gene that codes the characteristics for the heart muscle. When the gene defect is present the type of Hypertrophic Cardiomyopathy that develops varies greatly within the family. In addition, some people who have the Cardiomyopathy gene may never develop the disease.
• Hypertrophic Cardiomyopathy my be acquired, the result of high blood pressure.
• Nutritional deficiencies of essential vitamins and minerals such as thiamin (vitamin B-1), selenium, calcium and magnesium
• Pregnancy
• Excessive use of alcohol over many years
• Heart valve problems
• Heart tissue damage from a previous heart attack
• Chronic rapid heart rate

Symptoms

• Dyspnea +++
• Angina +++
• Syncope ++
• Symptoms typically are exertional

Signs

• Cardiac auscultation: mimics aortic stenosis with normal S1, normal S2, and dynamic crescendo-decrescendo, harsh systolic murmur that is heard best between the apex and left sternal border. The murmur is classically accentuated with decreased preload (standing or Valsalva) and is softer with increased preload (squatting).
• Carotid upstrokes are brisk, unlike aortic stenosis.

Treatment

Medication to help the heart work better and therefore relieve the symptoms tends to work well for many people. Those with Hypertrophic Cardiomyopathy are sometimes offered surgery to remove parts of the thickened heart muscle.

Medications help relax the heart and reduce the degree of obstruction so the heart can pump more efficiently. Beta-blockers and calcium channel blockers are two classes of medications that may be prescribed. If you have an arrhythmia, your doctor may prescribe medications to control your heart rate. Your doctor will discuss which medications are best for you.

The type of treatment prescribed depends on:

• How the heart is functioning
• Patient's symptoms
• Whether there is narrowing in the out-flow tract
• The age and activity level of the patient
• The presence of arrhythmias

Treatment is aimed at preventing symptoms, complications and includes risk identification and regular follow-up, lifestyle changes, medications and procedures as needed.