Hypertrophic cardiomyopathy ( HCM )

 

Hypertrophic Obstructive Cardiomyopathy (HCM) is a complex cardiac condition characterized by the thickening of the heart’s muscle wall, primarily affecting the left ventricle, left ventricle stiffness, Mitral valve changes and cellular changes. This condition can hinder the heart’s ability to pump blood efficiently and might lead to various symptoms and complications.

Incidence ; 

Hypertrophic cardiomyopathy affects an estimated 600,000 to 1.5 million Americans or 1 in 500 people. It is more prevalent than multiple sclerosis, a condition that impacts approximately 1 in 700 individuals.

 

Causes ;

The exact cause of HCM is unknown, but there are a number of factors that may contribute to the development of the condition, including:

• Genetic mutations proteins in the heart muscle are affected.
• Autosomal dominant inheritance pattern.
• Mutations in genes encoding sarcomere proteins.
• High blood pressure.
• Aging
• Often a familial condition, but sporadic cases can also occur.

Symptoms ;

Signs and symptoms of HCM include:

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Surgical Procedures ; 

 Various surgical and nonsurgical interventions can be employed for the treatment of hypertrophic cardiomyopathy (HCM):

• Septal Myectomy; One such procedure is septal myectomy, also known as septal reduction therapy. This involves open-heart surgery and the surgical excision of a portion of the thickened heart muscle. .
• Alcohol Septal Ablation;  Also called nonsurgical septal reduction therapy, Injecting alcohol into a specific artery to reduce the thickened muscle.
• Cardiac implantable electronic devices (CIEDs) ; It encompass various types of implants aimed at improving heart function., including:

1.  Implantable cardioverter defibrillator (ICD) – An ICD helps regulate a normal heartbeat by delivering an electric shock in response to the detection of an irregular heartbeat, thereby reducing the risk of sudden cardiac death .
2. Pacemaker – Its a small devices that utilize electrical pulses to stimulate the heart to beat at a normal rate, are employed for individuals with a heart rate that is excessively slow.
3. Cardiac resynchronization therapy (CRT) device – This device coordinates contractions between the heart’s left and right ventricles.

• Heart Transplant 

Prognosis ;

• Chest pain, especially with physical exertion
• Shortness of breath, especially with physical exertion
• Fatigue
• Arrhythmias (abnormal heart rhythms)
• Dizziness
• Lightheadedness
• Fainting (syncope)
• Swelling in the ankles, feet, legs, abdomen.

 

Associations ;

HCM progresses to other health problems ;

Atrial fibrillation ; This can lead to blood clots, stroke and other heart-related complications.

Sudden cardiac Arrest and Sudden cardiac death ; Sudden cardiac arrest and sudden cardiac death refer to the abrupt cessation of heart function triggered by an excessively rapid heartbeat, specifically ventricular tachycardia. In such instances, immediate emergency interventions, such as CPR and defibrillation, are crucial once symptoms manifest. Without timely administration of these treatments, the outcome can escalate to sudden cardiac death.

However, hypertrophic cardiomyopathy is the most common cause of sudden cardiac death in people under age 35 especially in young athletes .

Heart Failure ; If you have heart failure,  It means your heart doesn’t pump as well as it should. Symptoms of heart failure include:

• Difficulty breathing (shortness of breath).
• Feeling tired (fatigue) when you’re active.
• Swelling in your ankles, legs and abdomen.
• Need to urinate while resting at night.
• Dizziness, confusion, difficulty concentrating, fainting.
• Feeling that your heart is pumping too fast (palpitations).
• A dry, hacking cough.
• A full (bloated) , loss of appetite, or upset stomach.

Diagnosis ;

• Electrocardiogram (ECG) to detect abnormal heart rhythms.
• Stress tests to observe heart function during exercise.
• Cardiac MRI for detailed images of the heart’s structure.
• Genetic testing to identify mutations in relevant genes.

Treatment ;

Lifestyle modifications: Avoiding excessive physical exertion and dehydration.

Medications to manage symptoms and improve heart function:

• Beta-blockers are prescribed to decrease heart rate and alleviate strain on the heart. 
• Calcium channel blockers are used to induce relaxation and dilation of blood vessels. 
• diuretics are medications aimed at promoting the removal of excess fluid from the body.
• Anti-arrhythmic drugs to control irregular heartbeats.

 

May improve symptoms and function ,

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Surgical Procedures ; 

 Various surgical and nonsurgical interventions can be employed for the treatment of hypertrophic cardiomyopathy (HCM):

• Septal Myectomy; One such procedure is septal myectomy, also known as septal reduction therapy. This involves open-heart surgery and the surgical excision of a portion of the thickened heart muscle. .
• Alcohol Septal Ablation;  Also called nonsurgical septal reduction therapy, Injecting alcohol into a specific artery to reduce the thickened muscle.
• Cardiac implantable electronic devices (CIEDs) ; It encompass various types of implants aimed at improving heart function., including:

1.  Implantable cardioverter defibrillator (ICD) – An ICD helps regulate a normal heartbeat by delivering an electric shock in response to the detection of an irregular heartbeat, thereby reducing the risk of sudden cardiac death .
2. Pacemaker – Its a small devices that utilize electrical pulses to stimulate the heart to beat at a normal rate, are employed for individuals with a heart rate that is excessively slow.
3. Cardiac resynchronization therapy (CRT) device – This device coordinates contractions between the heart’s left and right ventricles.

• Heart Transplant 

Prognosis ;