Cardiomyopathy (Hypertrophic) (cont.)
How Is HCM Treated?
Treatment of HCM depends on whether there is narrowing in the path that blood takes to leave the heart (called
the outflow tract); how the heart is functioning; and if arrhythmias are present.
Treatment is aimed at preventing symptoms and complications, and includes lifestyle changes, medications
(such as beta blockers) and if necessary, a surgical procedure such as ethanol ablation or septal myecotomy or
an implantable device such as a pacemaker or implantable cardioverter defibrillators (ICD).
What Lifestyle Changes Are Recommended to Treat HCM?
- Diet. Once hypertrophic cardiomyopathy causes symptoms (even if the symptoms went away), you should restrict your
sodium (salt) intake to 2,000 to 3,000 mg per day.
- Exercise. Your doctor
will tell you if you may exercise or not. Most people with cardiomyopathy are
able to do non-competitive aerobic exercise. However, your doctor may ask you
not to exercise, based on your symptoms and the severity of your disease.
Heavy weight lifting is not recommended.
What Medications Are Used?
Often, medications are used to treat symptoms and prevent further complications. To manage heart failure, most people
improve by taking a beta-blocker , ACE inhibitors , and/or diuretics . People with HCM may improve with a calcium
channel blocker . If you have an arrhythmia , your doctor may give you medications to control your heart rate or lessen the
occurrence of arrhythmias. Your doctor will discuss what Cordarone are best for you.
What Surgical Procedures Are Used to Treat HCM?
Ethanol ablation.First, a cardiologist (heart doctor) performs a Cardiac Catheterization to locate the small
coronary artery that supplies blood flow to the septum. A balloon catheter is inserted into the artery and inflated.
A contrast agent is injected to locate the swollen septal wall that narrows the passageway from the left ventricle to the
aorta. When the bulge is located, a tiny amount of pure alcohol is injected through the catheter. The alcohol kills the
cells on contact, causing a small "controlled" heart attack.
The septum then shrinks back to a more normal size over the following months, widening the passage for blood flow.
Septal myectomy. During this surgical procedure, the surgeon removes a small amount of the thickened septal wall
of the heart to widen the outflow tract (the path the blood takes) from the left ventricle to the aorta.
Pacemaker.For some individuals, dual-chamber pacing (a pacemaker that senses and produces heartbeats in the
atrium and ventricle) improves symptoms. The reason why some people improve with a pacemaker and others don't is still
unknown. For people with heart block or some bradycardias (slow heart rates), a pacemaker is needed.
Implantable Cardioverter Defibrillators (ICD).ICDs are suggested for people at risk for life-threatening
arrhythmias or sudden cardiac death . The ICD constantly monitors the heart rhythm. When it detects a very fast,
abnormal heart rhythm, it delivers energy to the heart muscle to cause the heart to beat in a normal rhythm again.
Risk of Sudden Death and Endocarditis
A small number of people with HCM are at higher risk for sudden cardiac death. Those at risk include:
- Those who have family members who have had sudden cardiac death.
- Young people with HCM with several episodes of fainting.
- Those who have an abnormal blood pressure response with exercise.
- Adults who have a history of arrhythmia with a fast heart rate.
- Those with severe symptoms and poor heart function.
If you have two or more risk factors for sudden cardiac death, your doctor will treat you with medications to prevent
arrhythmias or with an ICD . Most people with HCM are at low risk for sudden cardiac death. Talk to your doctor about any
concerns you may have.
Next: How Can I Prevent Endocarditis? »
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