Hypertrophic Cardiomyopathy Information for Physicians

Clinical Identifiers

Hypertrophic cardiomyopathy (HCM) often goes undiagnosed despite its relatively high prevalence in the general population. This is because many people with HCM have minor or even no symptoms. However, there are several common signs and symptoms to be aware of in this population.

Rest and/or exertional angina
Dyspnea on exertion
Unexplained pre-syncope/syncope
Palpitations
A systolic murmur
Family history of hypertrophic cardiomyopathy
Family history of sudden cardiac death
Abnormal electrocardiogram/echocardiogram

Diagnostic Testing

If your patient presents with signs and symptoms of HCM, a family history of HCM, or an abnormal electrocardiogram/echocardiogram, please refer your patient to our center. This referral will allow your patient to benefit from a multidisciplinary approach to managing their condition. Specifically, we will perform tests including genetic testing and counseling, a transthoracic echocardiogram, a CV MRI and exercise stress testing. If a diagnosis is confirmed, we will work together to manage your patient’s HCM effectively.

Management

Because hypertrophic cardiomyopathy is inherited, it can't be prevented. However, it is important to identify the condition as early as possible to guide treatment and prevent complications. Maintaining a healthy lifestyle through weight, diet modification, and moderate-intensity aerobic exercise will help with symptoms and overall energy levels.

Specific treatment for HCM will be determined based on:

Age, overall health, and medical history
Extent of the disease
Presence/Absence of left ventricular outflow tract obstruction
Functional capacity
Perceived risk for sudden cardiac death
Tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Patient's opinion or preference

Medications/Devices

Many HCM patients successfully control their symptoms for years—even decades—solely with medication. We may recommend several different medical therapies:

Beta-blockers
Non-dihydropyridine calcium channel blockers
Various antiarrhythmic therapies
Anticoagulants
Myosin Inhibitors

Medical/device therapies function to achieve the following:

Decrease the overall cardiac workload
Improve left ventricular filling properties
Reduction of left ventricular outflow tract obstruction
Maintenance of normal sinus rhythm
Reduce the risk of stroke
Reduce the risk of sudden cardiac death

Surgical Treatment Options

A small fraction of patients will experience persistent, debilitating symptoms despite medical therapy that may, in turn, lead to an unacceptable quality of life. If this is the case and further treatment is required, your patient may be a candidate for procedures that will relieve left ventricular outflow tract obstruction to improve symptoms. Surgical treatments may include:

Surgical septal myectomy
Alcohol septal ablation
For the small subset of patients with advanced heart failure symptoms refractory to all medical and surgical therapies, cardiac transplant may still be an option.