Hypertrophic Cardiomyopathy - Treatment Overview
It is important for people with
hypertrophic cardiomyopathy to have frequent check-ups
with their doctors. People who are low-risk may not see their doctors as often.
But you may see the doctor more often if you have a change in your symptoms or
your overall health. When symptoms appear or start to get worse, a check-up
might include an
electrocardiogram (ECG, EKG), or exercise test. Your
doctor will talk about your symptoms and your health history. You may also talk
about the health history of people in your family. These regular visits will
help your doctor identify things that may put you at risk for sudden cardiac
death and other serious medical conditions.
If symptoms develop,
treatment is usually recommended. Medicines cannot cure hypertrophic
cardiomyopathy, but they may be used to treat complications, including
atrial fibrillation and
heart failure. After medicines are started, most
people need to take them for the rest of their lives.
Treatment if the condition gets worse
have serious heart rhythm problems or are at high risk for sudden death,
your doctor might recommend an
implantable cardioverter-defibrillator (ICD).
Medicines for heart failure may be used if
hypertrophic cardiomyopathy progresses to that
advanced state. For more information, see the topic
A surgery called a
myectomy or myomectomy may be advised for some people when medicines do not
help relieve severe symptoms of heart failure (NYHA class III and IV) due to hypertrophic cardiomyopathy. In this surgery, a portion of
overgrown heart muscle is removed. Often the excess muscle tissue is found in
the septum, which divides the left and right lower heart chambers (ventricles).
An overgrown septum can interfere with the function of the left ventricle and
limit blood flow out of the heart. Most people who have this surgery recover
well and end up with fewer symptoms. After surgery, physical activity is easier
Another option for people with hypertrophic cardiomyopathy
is nonsurgical septal reduction, also called alcohol septal ablation. When the area of the heart muscle that divides
the right and left chambers (septum) becomes too thick, the lower left heart
chamber (left ventricle) becomes obstructed, which hinders its ability to pump
normally. The thickened septum is reduced in size by injecting alcohol into the
coronary artery that supplies this area of the heart with blood. The alcohol
destroys some of the heart muscle in the thickened septum. This reduces the
obstruction and improves the left ventricle's pumping ability. Advantages of
this procedure are that major surgery and lengthy recovery are avoided because
the alcohol can be given through a catheter during a
cardiac catheterization procedure. This procedure can help relieve symptoms. But it is a newer procedure, so the long-term effects are not yet known. Experts recommend that this complex procedure be performed in a large
medical center where the staff has substantial experience with it.