Hypertrophic cardiomyopathy (HCM) is a form of cardiomyopathy. This is a condition in which the heart muscle thickens due to genetic problems with the muscle’s structure. As the muscle thickens, it must work harder to pump blood. This strains the heart muscle. Sometimes, the thickened muscle gets in the way of the blood leaving the heart and causes a blockage. This blockage can cause a nearby valve to become leaky. HCM can cause uneven muscle growth. This can cause the heart to pump in a disorganized way. Rarely, it can cause abnormal heart rhythms that can be fatal.

Normal Heart and Heart With Hypertrophic Cardiomyopathy

Hypertrophic Cardiomyopathy

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Causes

HCM may be caused by a gene that causes an abnormality in the heart muscle. It can be inherited or it can happen from changes in the genes over time.

Risk Factors

Having a family member with HCM is a risk factor for your child.

Symptoms

Symptoms may include:

  • Chest pain
  • Fainting, particularly during exercise
  • Lightheadedness, particularly following exercise
  • Rapid heartbeat
  • Shortness of breath or difficulty breathing
  • General fatigue
  • Tiring easily during exercise or activity

These symptoms can be caused by some of the side effects of the condition, including abnormal heart beats. The blocked or reduced blood flow is usually the cause of symptoms like lightheadedness, fainting, and difficulty breathing. Babies with the condition may have the following symptoms:

  • Fast, heavy breathing when feeding
  • Sweating when feeding
  • Tiredness or inactivity
  • Poor weight gain

Some children may not have any symptoms. The condition may be suspected if there is a murmur, although not every person with HCM has a murmur and not all murmurs are due to HCM.

Diagnosis

You will be asked about your child’s symptoms and medical history. A physical exam will be done.

Images may be taken of your child's bodily structures. This can be done with:

Your child's heart activity will be evaluated. This can be done with:

Your child's bodily fluids will be tested. This can be done with blood tests.

Treatment

Treatment focuses on controlling symptoms and preventing complications. Talk with the doctor about the best treatment plan for your child. Treatment options include:

Medications

Medications may be used to help maintain proper and regular heart function. They may also be used to remove excess fluid from the body. If your child has an arrhythmia, anti-arrhythmic drugs may be given. Your child may also need blood-thinning medication.

Surgery

The thickened portion of the heart muscle is cut and removed. This may be needed if your child has severely blocked blood flow from the heart or if the blockage causes a problem with the other heart valves and structures. If the mitral valve is leaking, surgery may also be done to repair or replace the mitral valve if needed.

Implantable Cardioverter Defibrillators (ICD)

An ICD is implanted if your child is at increased risk for sudden death.

Prevention

If a family member has been diagnosed with HCM, your child should be screened for the condition.