Hypertrophic cardiomyopathy

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Heart, section through the middle

Heart, front view

Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy

Alternative Names:

Cardiomyopathy - hypertrophic (HCM); IHSS; Idiopathic hypertrophic subaortic stenosis; Asymmetric septal hypertrophy (ASH).
Symptoms:

chest pain
fainting, especially during exercise
light-headedness, especially after activity or exercise
dizziness
sensation of feeling heart beat (palpitations)
shortness of breath

Additional symptoms that may occur are:

fatigue, reduced activity tolerance
shortness of breath when lying down

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Some patients with HCM have no symptoms, and may be unaware of their condition until it is detected during routine medical screening.

Unfortunately, the first symptom of HCM among many young patients is sudden death, caused by severe arrhythmias. HCM is a major cause of death in young athletes who seem completely healthy but die during heavy exercise.

Signs and tests:

The pulse in the arms and neck may have special characteristics. The doctor may feel an abnormal heart impulse in the chest. Listening with a stethoscope may reveal abnormal heart sounds or a murmur, which may change intensity with different body positions.

Most frequently, however, the physical examination of patients with HCM is relatively normal.

Left ventricular muscle thickness, obstruction of blood flow, or mitral valve regurgitation (malfunctioning of the valve between the left atrium and left ventricle) may appear on:

Echocardiography (the most common test) with Doppler ultrasound. For a more accurate evaluation, some patients need a transesophageal echocardiogram (TEE).
Chest x-ray
An ECG may indicate left ventricle muscle thickness, arrhythmias, previous heart attack, and/or ischemic changes. These changes are better captured by a 24-hour Holter monitor.
Cardiac catheterization

Lab tests are not specifically diagnostic for hypertrophic cardiomyopathy, but tests may be used to rule out other suspected diseases.

Your health care provider may recommend that your close blood relatives -- even if they have no symptoms -- also be tested for HCM.