Hypertrophic Cardiomyopathy

Some types of structural heart disease can affect people at any age, from adolescents and young adults to middle aged to elderly people. Hypertrophic cardiomyopathy (HCM) is one of these, a common condition that can lead to severe complications if left untreated.

At the Henry Ford Center for Structural Heart Disease, our internationally renowned cardiologists specialize in minimally invasive treatment for people with HCM.

What is hypertrophic cardiomyopathy (HCM)?

HCM is a common heart condition that causes the heart muscle to thicken. The condition usually affects the septum, the muscular wall between the left and right sides of the heart, and the left ventricle, which pumps oxygen-rich blood to the entire body. HCM can also occur in other walls of the heart.

HCM can develop slowly or occur suddenly. The condition becomes progressively worse. Over time, HCM causes changes in your heart function that include:

• The thickened muscle in the left ventricle and septum can narrow the left ventricle. This narrowing obstructs (blocks) blood flow through the aortic valve to the aorta (main artery of the body) and the rest of the body.
• The cells in the thickened muscle change in ways that can disrupt your heart’s natural rhythm, leading to arrhythmia.
• The cellular changes in the muscle interfere with its natural ability to relax and stretch. These changes cause the left ventricle to stiffen and reduce blood flow out of the heart. As a result, blood can pool in the lungs, leading to shortness of breath and other breathing problems.
• The thickened septum can impair the function of the mitral valve, further reducing blood flow outward into the body.

These changes prevent the heart from working properly. It must work harder to pump enough blood to the brain, vital organs and all parts of the body.

HCM can lead to potentially life-threatening complications such as heart failure (learn more about our Advanced Heart Failure Program), sudden cardiac arrest and sudden cardiac death. In sudden cardiac arrest, the heart abruptly stops beating without warning. Without immediate emergency medical treatment, sudden cardiac arrest leads to sudden cardiac death within minutes.

Causes and risk factors of hypertrophic cardiomyopathy

HCM is usually inherited, caused by mutations (abnormalities) in some genes in heart muscle proteins. However, some people with these genetic mutations never develop the disease.

In many cases, the cause of HCM is unknown. Certain factors may increase your risk of developing the condition, including:

• A family history of cardiomyopathy, heart failure or SCA
• Heart conditions such as heart attack, heart disease or a viral heart infection
• Other diseases such as diabetes, obesity, high blood pressure or thyroid disorders
• Severe, uncontrolled hypertension, (high blood pressure)

Symptoms of hypertrophic cardiomyopathy

Often, people who have HCM may not experience any symptoms. Your physician may find signs of the condition during a routine health exam.

If people do have symptoms, these may include:

• Shortness of breath and/or fatigue, to the point that physical activity becomes difficult or uncomfortable
• Chest discomfort or angina (chest pain) during physical activity, while at rest or after meals (less common)
• Heart palpitations or the sensation of extra or skipped heartbeats
• Light-headedness or fainting, especially during or after physical activity or after lying down for a period of time

Diagnosing hypertrophic cardiomyopathy

If you have any of these symptoms or risk factors, see your physician for an exam and screening to assess your risk of developing HCM. When your physician refers you to Henry Ford, we perform a complete evaluation, including:

• A physical exam, including checking for heart murmurs and other abnormalities
• A thorough review of your family medical history
• A detailed assessment of your symptoms

Your Henry Ford cardiologist may recommend additional testing, even if you have already had tests through your primary care physician. Find out more about how our expert cardiologists detect and identify HCM on our Diagnosis page.

Treatment for hypertrophic cardiomyopathy

Once we confirm a diagnosis of HCM, our structural heart specialists work together with you to develop a treatment plan customized to your needs. We consider these factors as we build your comprehensive plan:

• The severity of your symptoms
• Your current heart function, including whether blood flow out of the heart is restricted and whether you have an arrhythmia
• Your age and overall health

If you are not experiencing any signs or symptoms of HCM, you may not need treatment. We work with your primary care physician to monitor your heart function at periodic checkups. Your cardiologist may also recommend lifestyle changes to help you enjoy better health, such as:

• Moderate physical activity (and avoidance of strenuous activities)
• A healthy eating plan for optimal weight
• Smoking cessation

If you do have symptoms, you have several treatment options depending on your individual case. Our treatment goals are to:

• Minimize your symptoms so that you can continue your everyday activities
• Prevent the condition from worsening
• Manage other health conditions that affect HCM
• Reduce your risk of developing complications

At the Center for Structural Heart Disease at Henry Ford Hospital, our heart specialists are pioneers in the latest, most advanced procedures for conditions like HCM. We work together, combining our expertise from several fields of heart care to help you enjoy your best possible health.

Find out more about the leading-edge treatments we offer, including:

• 3D imaging and printing: We create 3D models of your heart that allow us to precisely plan your procedure ahead of time. These models help minimize procedure time, leading to the best outcomes. Learn more about 3D imaging and printing.
• Minimally invasive heart procedures: When possible, we offer a minimally invasive cardiac catheterization procedure called alcohol septal ablation to treat HCM without the need for open heart surgery. Find out about the other minimally invasive heart procedures that we offer.
• Medication management: If your symptoms are mild, medications may be enough to control your symptoms. Read about options for medication management for structural heart disease.
• Surgery: In addition to septal ablation, our experienced cardiac surgeons perform septal myectomy, a surgical technique to remove the thickened areas of heart muscle. Your care team can help you decide which option is best for you. Learn more about heart surgery at Henry Ford.