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Hypertrophic Cardiomyopathy - Treatment Overview

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It is important for people with high-risk 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 echocardiogram (echo), 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

If you 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 Heart Failure.

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 too.

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.

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WebMD Medical Reference from Healthwise

Last Updated: November 19, 2010
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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