Hypertrophic cardiomyopathy can be difficult to diagnose, because it may not always
cause symptoms. The first step in diagnosing heart problems is a thorough
medical history and physical exam.
Your doctor will ask you about
any family history of hypertrophic cardiomyopathy or any heart disease. Your
doctor will also want to know if any relatives died an early and sudden death.
Sometimes when young people die of cardiac arrest from hypertrophic
cardiomyopathy, the disorder is not discovered because autopsies are not always
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During the physical exam, your doctor will listen to
your heart with a stethoscope. If any extra or unusual heart sounds (gallops or murmurs) are heard, it may mean the
structure of the heart is abnormal.
You will usually have one or
more of the following tests to help your doctor diagnose and treat your
electrocardiogram (ECG or EKG) measures the electrical
activity as it moves through the heart during contraction and relaxation. An
abnormal electrocardiogram may be the first sign of hypertrophic cardiomyopathy
in people who do not have any symptoms.
echocardiogram (echo) is a type of ultrasound exam
that uses high-pitched sound waves to create an image of the heart, which is
seen on a television screen. An echo is the main tool used to help doctors
diagnose hypertrophic cardiomyopathy and find out how bad it is.
Echocardiography can be used to:
Estimate how well the lower left chamber of
the heart (left ventricle) is able to fill when the heart expands and measure
how much blood is pumped out as it contracts (ejection
Find out if the heart valves are functioning
Measure overall heart size.
Find out if the
heart muscle (myocardium), including the wall that separates the left and right
chambers of the heart, is unusually thick.
Measure the degree that
blood flow is reduced during contraction (systole) if the wall that separates
the left and right chambers of the heart is abnormally thick.
Physical exam, electrocardiogram, and echocardiogram are
the best ways to diagnose hypertrophic cardiomyopathy. People with a family
history of sudden death, especially young athletes or those who are thinking about
starting an exercise program, should talk to their doctors about being tested
for hypertrophic cardiomyopathy. These tests may also help evaluate a person
who faints during strenuous physical activity.
Patients who are
considered to be low risk will not see their doctor as often as patients
considered at high risk, usually around every 3 years. An echocardiogram is
usually done again if your symptoms change or get worse.
Your doctor may have you run on a
treadmill or pedal a stationary bike while he or she looks at how well your
heart and lungs are working. An exercise test can give the doctor (and you) an
idea of how hard and how long you can exercise.