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Hypertrophic cardiomyopathy is often asymmetrical, meaning that one part of the heart is thicker than other parts. HCM is usually passed down through families (inherited), and is believed to be a result of several defects in genes that control heart muscle growth.
To properly diagnosis HCM, our cardiologists use echocardiography or sound wave imaging to photograph the heart and to determine the thickness of its muscle. Normally, heart walls are 11 mm or less in thickness, but patients with HCM have a characteristic thickening of the heart’s walls that can range from 14 to 60 mm.
Patients with obstructive HCM have blockages inside the ventricular septum — the part of the heart that separates the right and left ventricles. The blockages restrict the flow of oxygenated blood from the left ventricle into the aorta, and ultimately into the body.
In patients with unobstructive HCM, the ventricle walls thicken, but not in a way to impede blood flow out of the heart. Rather, the chambers can’t sufficiently relax to fill with blood, making the pumping action inefficient. Patients with unobstructive HCM can experience shortness of breath, chest pain, and blackouts. However, they are usually at low risk of developing complications or of dying, and often require no treatment.
After a diagnosis of hypertrophic cardiomyopathy, each patient’s treatment plan is based on the severity of symptoms, whether they have obstructive or non-obstructive HCM, and any other mitigating circumstances.
Most hypertrophic cardiomyopathy patients with symptoms can be treated successfully with medications. Patients with obstructions or symptoms that do not respond to medication generally benefit from surgery. Patients who don’t want surgery or have other illnesses that would complicate a surgical solution may benefit from pacemakers.
Patients at risk for sudden death because of the presence of high-risk factors are treated with medication or implantable cardioverter defibrillators — devices that shock the heart back to a normal rhythm if a life-threatening irregular heartbeat occurs. Defibrillators are appropriate for only a minority of patients with HCM.
Mount Sinai St. Luke’s has a full range of primary care physicians and specialists.
Hypertrophic Cardiomyopathy Program
425 West 59th Street, Suite 9C
New York, NY 10019
Mount Sinai St. Luke’s1111 Amsterdam AvenueNew York, NY 10025(212) 523-4000