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Understanding HCM / oHCM

What is Hypertrophic Cardiomyopathy (HCM)?

HCM is a condition where the heart muscle becomes thicker than normal, which makes it harder for the heart to pump blood properly. The thickening usually affects the septum, the wall between the left and right sides of the heart. Understanding the difference between HCM and oHCM is important for proper treatment and management.

HCM Symptoms

  • Chest Pain: Often felt during or after physical activity.
  • Shortness of Breath: Difficulty breathing, especially when active.
  • Palpitations: Feeling like your heart is racing or pounding.
  • Fatigue: Feeling very tired or exhausted.
  • Dizziness or Fainting: Can happen if the brain isn't getting enough blood.

Diagnosis of HCM

  • Echocardiogram: An ultrasound that shows the thickened heart muscle.
  • MRI: Provides detailed images of the heart's structure.
  • Genetic Testing: Can identify if you have the gene that causes HCM.

oHCM Symptoms

  • All HCM symptoms, PLUS:
  • Increased Shortness of Breath: The blockage makes it harder for the heart to pump blood.
  • Frequent Chest Pain: The heart has to work harder to pump blood past the blockage.
  • Exertional Syncope: Fainting during or after exercise because the heart can't pump enough blood.

Diagnosis of oHCM

  • Echocardiogram with Doppler: Shows both the thickened heart muscle and how well blood is flowing.
  • Exercise Stress Test: Helps find out how severe the blockage is during exercise.
  • Cardiac Catheterization: Measures pressure inside the heart to check how much blood flow is blocked.

What is Obstructive Hypertrophic Cardiomyopathy (oHCM)?

oHCM is a specific type of HCM. In oHCM, the thickened heart muscle blocks blood flow out of the heart. This blockage can cause more symptoms and complications than HCM without obstruction.

Key Difference: While all patients with oHCM have HCM, not all patients with HCM have obstruction. The obstruction is what distinguishes oHCM from HCM and often requires more intensive treatment.

HCM Treatment

Medications:

  • Beta-blockers
  • Calcium channel blockers
  • Other drugs to help with symptoms

Lifestyle Changes:

  • Eat a healthy diet
  • Exercise regularly (but avoid heavy exercise)
  • Don't smoke

oHCM Treatment

Medications:

Similar to HCM, but with more focus on reducing the blockage.

  • Cardiac myosin inhibitors: Help by calming down the muscle, so the heart doesn't squeeze so forcefully. This helps the heart relax better and makes it easier for blood to flow in and out.

Procedures:

  • Septal Myectomy: Surgery to remove part of the thickened heart muscle.
  • Alcohol Septal Ablation: A non-surgical procedure where alcohol is injected to shrink the obstructed area.
  • Implantable Devices: Pacemakers or defibrillators to control heart rhythm problems.

Living with HCM and oHCM

Both conditions require regular visits to your heart doctor, taking medications as prescribed, and making lifestyle changes. Since these conditions can be passed down in families, it's important to consider genetic counseling and have family members screened.

Need more information?

Visit the HeartLife Academy for comprehensive video resources about HCM / oHCM and other cardiovascular health.

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