Hypertrophic Cardio­myopathy

Hypertrophic cardiomyopathy causes your heart muscle to thicken (especially the ventricles, or lower heart chambers). It can also make your left ventricle stiff and cause changes in your mitral valves and heart cells. This can cause:

• Ventricular arrhythmia.
• Ventricular tachycardia.
• Problems with blood flow.
• Heart failure.
• Sudden cardiac arrest.

Often, we don’t know what causes HCM. But high blood pressure, aging and even genetics can play a part in developing this condition.

What to expect during your first visit

When you first come to see us, we’ll ask you about your symptoms (if you have any), how long you’ve had them and if they’re getting worse.

Your provider will also do a physical exam. They’ll listen to your heart and lungs to see if they can hear a heart murmur — common with HCM. They might also do bloodwork and order some tests.

Imaging tests

These tests help us see if your heart muscle is thick and how well your heart is pumping blood:

• Echocardiogram (Echo).
• Electrocardiogram (EKG).
• Chest X-ray.
• MRI (magnetic resonance imaging).
• Exercise stress test.
• Cardiac catheterization.

Meet Our Hypertrophic Cardiomyopathy (HCM) Team

At Cleveland Clinic, you’ll have a handpicked team of providers who’ll work together to diagnose and treat your hypertrophic cardiomyopathy. Depending on your needs, your providers might include:

• Cardiologists.
• Interventional cardiologists.
• Cardiothoracic surgeons.
• Anesthesiologists.
• Radiologists.
• Nurse practitioners.
• Physician assistants.
• Cardiac rehabilitation specialists.
• Genetic counselors.
• Psychologists.
• Social workers.

Your care team will use your test results, physical exam and their conversations with you to guide your personalized treatment plan. They’ll consider your age, activity level, symptoms and well your heart is working when deciding the best way to treat your HCM.

Your provider will recommend treatments to reduce or stop your symptoms and cut your risk of complications, like heart failure and sudden cardiac arrest. Once diagnosed, you’ll likely have regular visits to check on your heart health.

Lifestyle changes

Making good choices when it comes to diet, exercise and tobacco, alcohol and recreational drug use can help make your heart as healthy as it can be. Our dietitians, cardiac rehab providers and psychologists can help you make lifestyle changes, if needed.

Medications

We may prescribe medications to treat your HCM symptoms and prevent complications. Mavacamten is the first FDA-approved drug specifically developed to target HCM. This innovative medication makes it easier for your heart to pump blood to the rest of your body. It has proven to have great success in reducing the symptoms of HCM and is often used as an alternative to surgery.

Other medications your provider might recommend include beta-blockers and calcium channel blockers to relax your heart muscle. You may also take medications that control your heart rate or lower your chance of having arrhythmias.

When you have hypertrophic cardiomyopathy, you’re also at risk for a serious infection called bacterial endocarditis. We may decide you need to take antibiotics to help prevent this.

Surgery

If your care team decides that you need surgery to treat your HCM, they may recommend:

• Septal myectomy: In this open-heart surgery, your surgeon will remove the thickened heart tissue so blood can flow better through your heart.
• Alcohol septal ablation: If you can’t have a septal myectomy, your provider may recommend this minimally invasive procedure. Your surgeon will put a balloon catheter (thin, flexible tube) into the artery that supplies blood to the thickened tissue and inflate the catheter. Then, they’ll inject a small amount of pure alcohol through the catheter. The alcohol destroys the cells that are causing the tissue to thicken and helps it shrink back to a more normal size.

Implantable arrhythmia detection device

If you’re at risk for life-threatening arrhythmias or sudden cardiac arrest, your provider may recommend an implantable cardioverter defibrillator (ICD). Placed just under your skin, this battery-powered device connects to your heart with wires. It sends an electric shock to your heart if it detects arrhythmia and can prevent sudden cardiac arrest.

Taking the Next Step

You may be shocked to learn you have a heart condition, like hypertrophic cardiomyopathy — especially if you don’t have symptoms. But the good news is, HCM is highly treatable, and in some cases, you might not need treatment at all to lead an active life. Whatever your needs, Cleveland Clinic’s top cardiology team can help your heart stay healthy with personalized, compassionate care.