hypertrophic cardiomyopathy 21

Hypertrophic cardiomyopathy (HCM) is a condition in which the heart muscle becomes thickened, making it harder for the heart to pump blood effectively.

Causes and Characteristics

• The heart muscle thickens due to abnormal genes or other factors [1].
• This thickening can lead to obstruction of blood flow out of the heart, particularly in the left ventricle [5][10].
• HCM can cause symptoms such as chest pain, shortness of breath, and fainting spells [11].

Types of HCM

• Hypertrophic obstructive cardiomyopathy (HOCM) is a type of HCM where the thickened heart muscle blocks blood flow out of the left ventricle [6].
• Other parts of the heart may also be affected by thickening, leading to reduced pumping ability [10].

Prevalence and Impact

• HCM is an autosomal dominant cardiac myocyte disease, meaning that a single copy of the mutated gene can cause the condition [9].
• It is a significant cause of sudden cardiac death in young people, including well-trained athletes [11].
• Men and women are equally affected across all races [11].

Treatment and Care

• Genetic testing and advanced care for families with heart disease are available at some medical centers [8].
• Comprehensive treatment and care options exist for HCM patients [8].
• Screening for HCM may be necessary, especially in individuals with a family history of the condition [14].

Common Signs and Symptoms of Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) can manifest in various ways, and it's essential to be aware of the possible symptoms. According to medical sources [2], some common signs and symptoms of HCM include:

• Chest pain: This is one of the most common complaints among people with HCM, often described as a squeezing or pressure sensation in the chest [6].
• Shortness of breath: Difficulty breathing, especially during exertion, is another frequent symptom [7]. This can be due to the thickened heart muscle making it harder for the heart to pump blood efficiently.
• Fatigue: Feeling tired or exhausted, even after minimal physical activity, is a common symptom in many cases [6].
• Palpitations: Irregular heartbeat or palpitations are also possible symptoms of HCM [5].
• Dizziness: Some people may experience dizziness or lightheadedness, especially when standing up quickly [10].

It's worth noting that not everyone with HCM will exhibit these symptoms, and some individuals might only experience them during physical activity or exertion. If you're experiencing any of these symptoms, it's crucial to consult a healthcare provider for proper evaluation and diagnosis.

References: [2] June 21, 2024 - Some people with hypertrophic cardiomyopathy don’t have symptoms while others may only feel symptoms with exercise or exertion. [5] Symptoms and Signs of Hypertrophic Cardiomyopathy · angina), · palpitations, and · syncope. Because systolic function is preserved, fatigability is seldom reported [6] Sep 19, 2024 — Among people who do develop symptoms, the most common complaints include chest pain, shortness of breath with exertion, fatigue, palpitations, ... [7] Difficulty breathing (shortness of breath) and fatigue, especially with exertion. These symptoms are more common in adults with hypertrophic cardiomyopathy. [10] Result: chest pain | heart symptoms | abnormal pulsations or palpitations | shortness of breath | dizziness

Diagnostic Tests for Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) can be diagnosed using various tests, which are essential in confirming the condition and ruling out other possible causes. Here are some of the key diagnostic tests used to diagnose HCM:

• Echocardiogram: An echocardiogram is the most common test used to diagnose HCM. It uses sound waves to create images of the heart's structure and function, showing thickening of the heart walls [4][5].
• Electrocardiogram (ECG): An ECG can show abnormal electrical activity in the heart, which may indicate HCM [8].
• Cardiac Magnetic Resonance Imaging (MRI): MRI can provide detailed images of the heart's structure and function, helping to confirm a diagnosis of HCM [3][8].
• Genetic testing: Genetic testing can identify gene mutations that cause HCM. This test is particularly useful for individuals with a family history of the condition [2][6].

These diagnostic tests are essential in confirming a diagnosis of hypertrophic cardiomyopathy and ruling out other possible causes.

References:

[1] NYU Langone doctors conduct a physical exam, imaging studies, and, sometimes, genetic tests to diagnose HCM. [2] Genetic testing can be done from a blood sample. It is important for two reasons: patients can find out more about their own prognosis, and they learn if family members are at risk. [3] Feb 27, 2020 — Echocardiography is the key to diagnosis and MRI may play a future role in sudden death risk stratification. [4] May 29, 2024 — Diagnosis is typically done by echocardiogram. It checks the function and thickness of the heart muscle and how the blood flows through the heart. [5] An echocardiogram is the most common test used to diagnose hypertrophic cardiomyopathy, as this test will usually show the thickening of your heart walls. [6] Genetic testing can be done from a blood sample. It is important for two reasons: patients can find out more about their own prognosis, and they learn if family members are at risk. [7] Diagnosing and treating hypertrophic cardiomyopathy often involves blood tests, imaging, and other tools. [8] by DL Jacoby · 2013 · Cited by 60 — An electrocardiogram (ECG), echocardiogram and cardiac magnetic resonance imaging (MRI) from a patient with hypertrophic cardiomyopathy are shown in Appendix 1.

Treatment Options for Hypertrophic Cardiomyopathy (HCM)

Hypertrophic cardiomyopathy (HCM) is a condition where the heart muscle becomes thickened, leading to obstruction in blood flow. While there is no cure for HCM, various treatment options can help manage symptoms and improve quality of life.

Medications

Several medications are commonly prescribed to treat HCM:

• Beta blockers: These medications slow down the heart rate and reduce the force of contraction, thereby reducing the obstruction in the heart. [1][2]
• Disopyramide: This medication can help reduce the thickness of the heart muscle and improve symptoms. [3][4]
• Calcium channel blockers: These medications can also help reduce the obstruction in the heart by relaxing the heart muscle. [5][6]
• Heart rhythm medications: In some cases, medications may be prescribed to regulate abnormal heart rhythms associated with HCM.
• Anticoagulants: If there is a risk of blood clots, anticoagulant medications may be prescribed to prevent clot formation.

Newer Treatment Options

Recently, a new medication called mavacamten (Camzyos) has been approved by the FDA for the treatment of obstructive HCM. Mavacamten works by reducing the obstruction in the heart caused by HCM, thereby improving exercise capacity and quality of life. [7][8]

First-Line Treatment

The first-line treatment for obstructive HCM is typically beta blockers, which can be replaced by verapamil if the patient does not tolerate them. Disopyramide may also be considered as an alternative treatment option. [9]

Cardiac Myosin Inhibitors

In some cases, cardiac myosin inhibitors like mavacamten may be recommended as therapy for patients with obstructive HCM who have symptoms due to left ventricular outflow tract obstruction. [10]

It's essential to note that each patient's condition is unique, and the most effective treatment plan will depend on individual factors such as symptom severity, heart function, and overall health.

References:

[1] Feb 23, 2024 — Mavacemten (Camzyos) is a medication for hypertrophic cardiomyopathy that reduces strain on the heart. [2] Jul 25, 2022 — Mavacamten, taken orally, reduces the obstruction in the heart caused by HCM. [3] Commonly prescribed medications for HCM include beta blockers, disopyramide, calcium channel blockers, heart rhythm medications, and anticoagulants. [4] by C Palandri · 2022 · Cited by 39 — Guideline-directed therapy of HCM includes non-selective drugs such as disopyramide, non-dihydropyridine calcium channel blockers, or β-adrenergic receptor ... [5] Nov 9, 2020 — The new, investigational heart medication mavacamten may improve key structural abnormalities of obstructive hypertrophic cardiomyopathy. [6] Apr 2, 2022 — Medications like beta-blockers, calcium channel blockers, and antiarrhythmics can be prescribed to treat hypertrophic cardiomyopathy symptoms ... [7] Apr 29, 2022 — FDA approves Camzyos (mavacamten) capsules for adults with symptomatic obstructive hypertrophic cardiomyopathy (oHCM), improving exercise ... [8] May 29, 2024 — Mavacamten is the only FDA-approved medication for HCM, which treats obstructive form of HCM in people with symptoms. [9] by W Xu · 2024 — The first line treatment for obstructive HCM is β-blockers, and they can be replaced by verapamil if the patient does not tolerate. Disopyramide ... [10] Jun 27, 2024 — Cardiac myosin inhibitors are now recommended as therapy for patients with obstructive HCM who have symptoms due to left ventricular outflow ...

The differential diagnosis for hypertrophic cardiomyopathy (HCM) involves ruling out other conditions that can cause similar symptoms and physical findings. Some of the key considerations in the differential diagnosis of HCM include:

• Systemic hypertension: This is a common cause of acquired left ventricular hypertrophy, which can mimic the thickened left ventricle seen in HCM.
• Aortic stenosis: Another condition that can cause left ventricular hypertrophy and potentially lead to similar symptoms as HCM.
• Physiologic remodeling due to fitness: Athletes may develop physiologic remodeling of their hearts, which can manifest with left ventricular hypertrophy and mimic the appearance of HCM on echocardiography.
• **Increased left ventricular wall thickness due to acquired