Hypertrophic Cardiomyopathy : Symptoms, Causes and Treatment

Hypertrophic Cardiomyopathy : Symptoms, Causes and Treatment

Hypertrophic cardiomyopathy (HCM) is a medical condition in which the heart muscle becomes thick (hypertrophied). As a consequence, it becomes harder for the heart in pumping blood. HCM often goes undetected in many people as...

Hypertrophic cardiomyopathy (HCM) is a medical condition in which the heart muscle becomes thick (hypertrophied). As a consequence, it becomes harder for the heart in pumping blood. HCM often goes undetected in many people as there could be no apparent signs or symptoms.

Only a small section of people can have symptoms precipitated by the thickened heart muscles. They experience shortness of breath, chest pain, or abnormality in the heart’s electrical system - which could be life-threatening. 

Often HCM leads to stiffness in the left ventricle, changes in the mitral valve, and cellular changes. 

HCM may cause several serious health conditions, which include:

  • Atrial fibrillation. It is a type of arrhythmia that can lead to blood clots
  • Stroke
  • Heart failure
  • Ventricular arrhythmias can cause a cardiac arrest

There are other serious complications as well, which are discussed below in the later part of the article. 

What are the symptoms of hypertrophic cardiomyopathy?

Although most people may not have any symptoms of hypertrophic cardiomyopathy, others may exhibit some of the following symptoms:

  • Chest pain while doing exercise
  • Fainting, mainly during an exercise session or just after it or in any exertion
  • A murmur in the heart (it can be detected by a doctor while listening to the heart)
  • Palpitations (which is a sensation of fast, fluttering, or pounding heartbeats) 
  • Shortness of breath, particularly during exercise or any physical activity 

What are the causes of hypertrophic cardiomyopathy?

One of the main causes of hypertrophic cardiomyopathy is changes in genes (gene mutations). It leads to the thickening of the heart muscle. 

HCM typically changes the muscular wall, called the septum between the two bottom chambers of the heart called ventricles. The thickened wall sometimes blocks blood flow out of the heart. It is then called obstructive hypertrophic cardiomyopathy.

But, when there is no significant blockage of blood flow, this condition is called non-obstructive hypertrophic cardiomyopathy. However, when the heart's main pumping chamber (left ventricle) stiffens, it is hard for the heart to relax. There is a reduction in the amount of blood the ventricle can hold and sends to the body with each heartbeat. 

There is also a rearrangement of heart muscle cells (myofiber disarray) in people with HCM, which can trigger arrhythmias in some of them.  

Who are vulnerable to HCM?

People need to understand the risk factors of hypertrophic cardiomyopathy. It is usually hereditary and one’s genes are to be blamed for it. Even if one parent has hypertrophic cardiomyopathy, the chances grow by 50% for the ward to have a genetic mutation for the disease. 

So, anyone who has a family member with hypertrophic cardiomyopathy should be cautious and go for screening for the disease. 

Know when to visit a doctor

It is very important to know when to visit the doctor to be on the safer side. So, whenever there is shortness of breath and it seems fast along with pounding heartbeats, one should visit a doctor. It can be the result of many ultrasound conditions and heeding the doctor’s advice promptly will ensure accurate diagnosis and appropriate care at the right time. 

Moreover, when there is a family history of HCM or any symptom of hypertrophic cardiomyopathy becomes visible, one should pay a visit to the doctor and be in constant touch. Keep an emergency healthcare facility number handy and call them immediately in case any of the following symptoms show up for a few minutes:

  • Difficulty breathing
  • Rapid or irregular heartbeat
  • Chest pain

Let’s discuss some risk factors for hypertrophic cardiomyopathy:

Knowing the risk factors can also go a long way to be vigilant of the situation, and prevent HCM to a great extent. As already discussed, it is hereditary. It is a condition that is usually passed down x-rays through families. Even if it is with one parent, there is a 50% chance for the children to have a genetic mutation for HCM.

So, it is recommended that if anyone in the family has it, the others should go for the screening for hypertrophic cardiomyopathy.

The complications from hypertrophic cardiomyopathy

Atrial fibrillation: When a heart muscle thickens and there are changes in the structure of heart cells, it alters the heart's electrical system. As a result, heartbeats become fast or irregular. Atrial fibrillation can increase the risk of developing blood clots, which cause a brain stroke.

Mitral valve disease: As a consequence of the thickened heart muscle the blood flow leaving the heart gets blocked, and the valve between the left atrium and left ventricle (mitral valve) might not close properly. So, blood can leak backward into the left atrium (mitral valve regurgitation), worsening the symptoms. 

Blocked blood flow: Due to the thickening of the heart muscle the blood flow leaving the heart gets blocked. It leads to shortness of breath, exertion, dizziness, chest pain, and fainting spells.

Dilated cardiomyopathy: For a very small section of patients with HCM, the thickened heart muscle goes weak and ineffective. The enlarged ventricle then pumps with less capacity.

Fainting: It is termed as syncope medically. Sometimes, fainting is caused due to an irregular heartbeat and blockage of blood flow. Unexplained fainting can be linked to sudden cardiac death, especially if it has happened recently and in a young person.

Heart failure: Eventually the thickened heart muscle becomes very stiff and becomes incapable to fill the heart with blood. Consequently, the heart fails to pump sufficient blood to meet the requirement of the body. 

Sudden cardiac death: Hypertrophic cardiomyopathy may rarely cause heart-related sudden death in people of any age. It is because so many people fail to realize or are unaware that they have hypertrophic cardiomyopathy. And sudden cardiac death might be the first sign of the disease. Surprisingly, it can inflict seemingly healthy young people like high school athletes and other young, active adults. 

Are there any preventive measures for hypertrophic cardiomyopathy?

For a heart condition that has a genetic disposition, there are no preventive measures for hypertrophic cardiomyopathy. However, pet scans realizing and finding the symptoms at the earliest can help immensely in getting treatment and preventing further complications. 

Since it is hereditary, someone with a first-degree relative whether it is a parent, sibling, or child with hypertrophic cardiomyopathy, should go for genetic testing to see for the disease. 

However, it does not mean that everyone with HCM has a currently detectable mutation. 

It is worth mentioning that it is the reason why some insurance companies exclude genetic testing.

In case of unsatisfactory results of genetic testing or if it is not done, doctors might advise repeated echocardiograms for people with hypertrophic cardiomyopathy in the family. 

People who are susceptible to a family history of hypertrophic cardiomyopathy should go for regular screening, which is once a year. Even adolescents and competitive athletes should do this once a year. Adults who don’t compete in competitive sports should go for it once in five years as a preventive measure. 


One cannot do much with a hereditary factor in conditions like hypertrophic cardiomyopathy. But, by being aware and with regular screening of the condition and maintaining a healthy lifestyle, people can remain safe and go about in life like others to a great extent. 

Even normal healthy people should be conscious of maintaining a healthy heart by adopting all lifestyle changes required for it. Having a healthy heart is a gift and people should not meddle by indulging in ct scans habits that can be detrimental to it. Eating right, exercising, and having a happier disposition with noble human qualities are the basic requirements to enjoy a great heart health.