cardiomyopathy (say "hy-per-TROH-fik kar-dee-oh-my-AWP-uh-thee") happens when
the heart muscle grows too thick, so the heart gets bigger and its
chambers get smaller. Many people
have no symptoms and live a normal life with few problems. But in some people with this condition:
heart doesn't get enough blood and oxygen, which can cause chest pain.
A fast, slow, or uneven heartbeat (arrhythmia) develops. In rare cases, this can cause sudden death.
The heart doesn't pump
blood well, or it doesn't relax between beats as it should. In rare cases,
this can lead to
People who exercise
often and hard may have changes in their heart muscle that can
be confused with hypertrophic cardiomyopathy. This condition is
called athlete's heart syndrome. It is harmless. When an athlete stops
training, the heart will return to a normal size.
What causes hypertrophic cardiomyopathy?
genes cause the heart to grow more than it should.
cardiomyopathy is the most common
genetic disease of the heart. This means it runs in families. About 1 in 500 adults has this condition.1
You are at risk for hypertrophic
cardiomyopathy if either of your parents or a brother or sister has it or
died suddenly at a young age. Talk to your doctor about
What are the symptoms?
You may not have any symptoms. Or you might:
Feel tired and
short of breath when you are active.
pain (angina). You may have a heavy, tight feeling in your
chest. Chest pain is often brought on by exercise, when the heart has to work
Feel dizzy or faint, often
after you have been active.
Feel like your heart is pounding,
racing, or beating unevenly (palpitations).
A rapid or irregular heartbeat or
fainting spells are signs of an arrhythmia, which makes sudden death more
How is hypertrophic cardiomyopathy diagnosed?
Your doctor will do a physical exam and ask you about any health problems you've had and about
any family history of heart disease or early and sudden death. You may need tests such as:
Your doctor may refer
you to a doctor who specializes in heart problems (cardiologist). Based on your
symptoms, past health, and family history, the specialist can assess your risk
for sudden death. People who are at high risk will need regular checkups. If you are at low risk for sudden death, you may not need to see your doctor often. But you will need a checkup anytime your symptoms change or get worse.
How is it treated?
Many people who have hypertrophic
cardiomyopathy don't have symptoms and don't need treatment. If you do have symptoms, your treatment will depend on what your symptoms are and
whether you develop heart failure or an abnormal heart rhythm.
You may take medicines to treat symptoms such
as shortness of breath and chest pain.
If you get a serious heart rhythm problem such as
atrial fibrillation, you may take medicines to control your heart rate or rhythm and to prevent blood clots. Or you may get
cardioversion, an electrical shock to return the heart
to its normal rhythm.
If medicines don't work and your heart isn't pumping blood well, you might have a procedure to reduce the size of the overgrown part of your heart. The overgrown part can be removed with a surgery called myectomy. Or it can be destroyed by injecting alcohol into the
artery that supplies that part of the heart. This procedure is called nonsurgical septal reduction, or alcohol septal ablation.
What can you do at home for hypertrophic cardiomyopathy?
Avoid strenuous activity and intense exercise. Your doctor can tell you what level
of exercise and what kinds of activities are safe for you.
Be active at a safe level to help keep your heart and body healthy.
If you smoke, quit. Your doctor can tell you about medicines and counseling that can help you quit for good.
Drink plenty of fluids
(unless your doctor has told you to limit
your fluid intake).
Ommen SR, et al. (2011). Hypertrophic cardiomyopathy. In V Fuster et al., eds., Hurst's The Heart, 13th ed., vol. 1, pp. 817–864. New York: McGraw-Hill.
Other Works Consulted
Fifer MA, Vlahakes GJ (2008). Management of symptoms
in hypertrophic cardiomyopathy. Circulation, 117(3):
Gersh BJ, et al. (2011). 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 124(24): e783–e831.
Ho CY (2012). Hypertrophic cardiomyopathy in 2012. Circulation, 125(11): 1432–1438.
Maron BJ (2012). Hypertrophic cardiomyopathy. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 2, pp. 1582–1594. Philadelphia: Saunders.
McKenna WJ, Elliott PM (2007). Hypertrophic
cardiomyopathy. In EJ Topol, ed., Textbook of Cardiovascular Medicine, 3rd ed., pp. 482–501. Philadelphia: Lippincott Williams and
Primary Medical Reviewer
Adam Husney, MD - Family Medicine
Specialist Medical Reviewer
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
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