5 things to know about hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a heart condition that affects the structure and function of the cardiac muscle, making it more difficult for the heart to pump blood. HCM can contribute to several serious complications, including heart failure, stroke, and sudden cardiac arrest.

If you or a loved one is living with HCM, here are five important things to understand about the condition.

1. Obstructive and non-obstructive HCM

HCM can be classified into two main types—obstructive and non-obstructive.

• Obstructive HCM occurs when the heart muscle becomes abnormally thickened, making it difficult for the heart to pump blood to the rest of the body. This can cause symptoms like chest pain, shortness of breath, and fatigue.
• Non-obstructive HCM also involves thickening of the heart muscle, but it does not interfere with the heart’s ability to pump blood. Symptoms in non-obstructive HCM may vary. Some experience mild symptoms, others experience no symptoms.

2. Symptomatic and asymptomatic HCM

HCM can manifest in two ways—symptomatic and asymptomatic.

• Symptomatic HCM refers to HCM that causes chest pain, shortness of breath, abnormal heart rhythms, fainting, or other symptoms. Symptoms may occur at rest or may occur or worsen during physical exertion.
• Asymptomatic HCM indicates that a person does not exhibit any noticeable symptoms. However, even in the absence of symptoms, HCM can still put a person at risk for life-threatening complications—and it requires monitoring and management.

3. HCM can get worse over time

Hypertrophic cardiomyopathy is often a progressive condition, meaning it gets worse over time, and the risk of complications increases with time, especially when left untreated. Even if a person is not experiencing symptoms at the time of diagnosis, they may experience symptoms in the future.

4. Family screening is crucial

Hypertrophic cardiomyopathy is caused by genetic mutations that are inherited from a person’s parents. If one member of a family has HCM, other members of that family may have HCM too.

Blood relatives of people living with HCM should see a cardiologist—ideally, one who is experienced in diagnosing HCM. Genetic testing and working with a genetic counselor can also help guide treatment for people living with HCM and their family members who are at risk, including children.

5. HCM can be treated

There is no cure for HCM, and the aim of treatment is to manage symptoms, prevent complications, and enable people with the condition to enjoy a good quality of life.

A treatment plan will depend on whether HCM is obstructive or non-obstructive, the symptoms that a person is experiencing, and many additional factors about the person with HCM and their medical history. Treatment can include:

• Lifestyle modifications, including avoiding strenuous activity, avoiding dehydration, maintaining a healthy weight, and other steps to keep the cardiovascular system healthy.
• Medications to treat symptoms and prevent complications caused by HCM, such as chest pain, shortness of breath, irregular heart rhythms (arrythmias), blood clots, and stroke.
• Surgical and nonsurgical procedures to remove or reduce the amount of thickened muscle in the heart.
• Medications called cardiac myosin inhibitors, which help the heart contract with less force and reduce the abnormal thickening of the heart muscle. The first of these medications was approved in 2022.

Not every type of treatment is right for every person with HCM. If you or a loved one has been diagnosed with HCM, your healthcare provider will be your best source of information.