To help identify the underlying cause of your hypertrophic cardiomyopathy (HCM), you may need to have genetic testing. HCM is primarily a hereditary/genetic condition that runs in families, affecting multiple generations. Therefore, your family members (such as your parents, brothers, sisters and children) are likely at risk of also developing this condition. Learn more about genetic counseling through our Hypertrophic Cardiomyopathy Clinic.
Beta-blockers, calcium channel blockers and disopyramide
Many patients with HCM can manage their symptoms with these standard medications. Beta-blockers and calcium blockers can help slow down your heart rate or reduce the strength of the contractions of the heart muscle to keep your heart working efficiently. An antiarrhythmic medication called disopyramide can be considered if beta-blockers or calcium channel blockers fail control symptoms in obstructive HCM.
Our patients will undergo a thorough evaluation to determine whether there is a risk of dying suddenly from a dangerous heart rhythm (ventricular tachycardia or fibrillation). If there is a significant risk, we will offer placement of an implantable defibrillator. An implantable cardioverter defibrillator (ICD) looks very similar to a pacemaker, except that it is slightly larger. It has a generator, one or more leads and an electrode for each lead. These components work very much like a pacemaker. However, the ICD is designed to deliver an electrical shock to the heart when the heart rate becomes dangerously fast, or "fibrillates." An ICD senses when the heart is beating too fast and delivers an electrical shock to convert the fast rhythm to a normal rhythm.
Some devices combine a pacemaker and ICD in one unit for persons who need both functions. After the shock is delivered, a "back-up" pacing mode is available if needed for a short while. The ICD has another type of treatment for certain fast rhythms called anti-tachycardia pacing (ATP). When ATP is used, a fast pacing impulse is sent to correct the rhythm.
If additional medications (such as disopyramide) and other therapies are not effective to treat your HCM, you may need surgery to remove a portion of the thickened heart muscle: This is called septal reduction.
Septal reduction can be performed either by catheter-based, alcohol septal ablation or with a surgical septal myomectomy.
Atrial fibrillation treatment
Some people may have atrial fibrillation - an irregular or fast heartbeat - as part of HCM. This can be treated with a variety of treatment options.
An anticoagulant is a medication given to prevent your blood from clotting or keep existing blood clots from getting bigger. Some of these drugs are called heparin, warfarin and dabigitran.
If you have HCM, anticoagulants can keep harmful clots from forming in your heart, veins or arteries. Clots can block blood flow and cause a heart attack or stroke.
Heart failure treatment
In more advanced cases, we may recommend evaluation by our heart failure experts. We have options available in the form of mechanical ventricular assist devices or even heart transplantation.