Hypertrophic Cardiomyopathy: How Does It Progress?

Hypertrophic cardiomyopathy (HCM) is a complex heart condition which can disrupt the heart’s normal functioning. While HCM is often inherited, it can also develop due to genetic mutations or underlying health conditions (1). Managing HCM involves a multidisciplinary approach that includes medical interventions, lifestyle modifications, and dietary changes.

In this article you will learn:

• What is Hypertrophic Cardiomyopathy?
• What are the Symptoms of Hypertrophic Cardiomyopathy?
• What are the Causes of Hypertrophic Cardiomyopathy?
• What is the Treatment for Hypertrophic Cardiomyopathy?
• What is a Hypertrophic Cardiomyopathy Diet?

Hypertrophic cardiomyopathy (HCM) is a genetic heart condition characterised by abnormal thickening (hypertrophy) of the heart muscle, especially the left ventricle. This thickening can cause stiffness in the heart muscle, impairing its ability to relax and fill with blood properly. As a result, the heart may struggle to pump blood effectively to the rest of the body, leading to symptoms such as shortness of breath, chest pain, fatigue, and fainting spells (1).

Despite being a genetic condition, the severity and manifestation of HCM can vary widely among individuals. While some may experience debilitating symptoms from an early age, others may remain asymptomatic for much of their lives. However, HCM can pose significant health risks, including an increased risk of heart failure, arrhythmias, and sudden cardiac death.

Symptoms of HCM can range from mild to severe and may include (2):

• Shortness of breath, especially during physical exertion
• Chest pain or discomfort, often triggered by exercise or stress
• Fainting spells or dizziness, particularly during exertion
• Palpitations or irregular heartbeats

Diagnosing HCM typically involves a combination of medical history review, physical examination, and diagnostic tests. Echocardiography, a type of ultrasound imaging, is commonly used to assess the thickness of the heart muscle and evaluate its function. Genetic testing may also be recommended, especially for individuals with a family history of HCM or sudden cardiac death.

Hypertrophic cardiomyopathy is primarily caused by mutations in genes responsible for the structure and function of the heart muscle. These genetic mutations can lead to abnormal growth and thickening of the heart muscle, impairing its ability to function properly. While HCM is often inherited in an autosomal dominant pattern, meaning it can be passed down from one parent who has the condition, it can also occur spontaneously due to new genetic mutations.

In addition to genetic factors, several other risk factors may contribute to the development or progression of HCM, including (2):

• High blood pressure
• Obesity
• Diabetes
• Thyroid disorders
• Certain medications, such as chemotherapy drugs or medications that affect heart rhythm

Treatment for hypertrophic cardiomyopathy aims to alleviate symptoms, prevent complications, and reduce the risk of sudden cardiac death. The treatment approach may vary depending on the severity of symptoms and the presence of complications. Treatment options may include (3):

• Medications: Certain medications, such as beta-blockers, calcium channel blockers, and antiarrhythmic drugs, may be prescribed to help manage symptoms and prevent complications.
• Surgical procedures: In some cases, surgical interventions may be necessary to relieve obstruction of blood flow or correct other structural abnormalities. Septal myectomy, a surgical procedure to remove a portion of the thickened heart muscle, is often recommended for individuals with severe symptoms or obstruction.
• Implantable devices: Devices such as implantable cardioverter-defibrillators (ICDs) or pacemakers may be recommended for individuals at high risk of life-threatening arrhythmias or sudden cardiac death.

In addition to medical treatment, lifestyle modifications play a critical role in managing HCM and improving overall heart health. These modifications may include (4):

• Regular exercise: Physical activity is essential for maintaining cardiovascular fitness and overall health. However, individuals with HCM should consult with their healthcare provider before starting or modifying an exercise program. Low-impact activities such as walking, swimming, or cycling may be recommended, while high-intensity or competitive sports may need to be avoided.
• Stress management: Stress can exacerbate symptoms of HCM and contribute to cardiovascular risk. Practicing relaxation techniques such as deep breathing, meditation, or yoga can help reduce stress and promote overall well-being.
• Avoidance of harmful substances: Smoking, excessive alcohol consumption, and illicit drug use can all have negative effects on heart health and should be avoided.

By adopting heart-healthy habits and making positive lifestyle changes, individuals with HCM can improve their quality of life, reduce symptoms, and lower their risk of complications.

Dietary modifications are an essential aspect of managing HCM and promoting heart health. While there is no specific “Hypertrophic Cardiomyopathy diet,” adopting a heart-healthy eating pattern can help individuals with HCM better manage their condition and reduce their risk of complications. Key dietary recommendations for individuals with HCM may include (4):

By following these dietary recommendations and making healthy food choices, individuals with HCM can support their heart health and overall well-being. Consulting with an Accredited Practising Dietitian can provide additional guidance and support.

Hypertrophic cardiomyopathy is a complex heart condition that requires comprehensive management, including medical treatment, lifestyle modifications, and dietary changes. By understanding the importance of maintaining a heart-healthy lifestyle and following medical advice, individuals with HCM can improve their quality of life and reduce the risk of complications. It’s essential to work closely with healthcare professionals to develop a personalised treatment plan that meets individual needs and promotes long-term heart health