Care and Treatment for Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy, a common type of cardiomyopathy, is a disease of the heart muscle that may run in families. It may cause no symptoms, but it can lead to serious complications. Duke cardiologists are experts in the diagnosis and management of cardiomyopathy and ensure you receive the right treatment for the heart conditions that can occur as a result. We help people with hypertrophic cardiomyopathy live normal lives.
Cardiomyopathy is a group of diseases that affect the heart muscle. The most common type, hypertrophic cardiomyopathy, occurs when the heart muscle wall thickens. This makes the muscle work harder, and the thicker muscle can obstruct the flow of blood exiting the heart. It often goes undiagnosed because many people have no or only mild symptoms. It is notorious for causing sudden death in young athletes but can affect people of all ages and activity levels.
Duke cardiologists are experts in treating all types of cardiomyopathy including:
- Hypertrophic cardiomyopathy, which may be obstructive or non-obstructive, depending on what part of the heart muscle thickens and whether that prevents blood from flowing out of the left ventricle.
- Dilated cardiomyopathy, in which the heart size is larger, but muscle walls are thinner and weaker and normal.
- Restrictive cardiomyopathy, a rare condition that occurs when the lower chambers of the heart become rigid and stiff, which restricts filling of the heart during muscle relaxation.
Any type of cardiomyopathy can occur without a known cause, be present without symptoms, and cause serious heart problems including life-threatening arrhythmias, mitral valve disease, and heart failure. Identifying the disease early, and working with cardiologists who are experts in its diagnosis and management, will prevent cardiomyopathy from progressing and causing serious complications.
A Team of Experts Treats Your Hypertrophic Cardiomyopathy
Our cardiologists are experts in managing cardiomyopathy and work with other Duke cardiologists who are specialists in the related heart problems that can arise. Our comprehensive evaluation results in a treatment plan personalized to your condition.
- We use advanced imaging techniques, such as cardiac MRI, to diagnose cardiomyopathy and confirm its type. Our heart imaging experts' use of and skill with advanced imaging also helps us define the location and extent of related heart problems.
- Hypertrophic cardiomyopathy can run in families, which is why genetic testing is often recommended. If genetic testing determines that one or more of your family members carries a gene linked to hypertrophic cardiomyopathy, our genetic counselors educate them about potential concerns and proactive steps they can take to lower their risk for future heart problems.
- As a Duke patient, you may be eligible to participate in clinical trials that offer access to new therapies, procedures, or devices that aren’t widely available.
- If a heart rhythm disorder is suspected, our electrophysiologists recommend a range of options to keep your heart in rhythm, from medications to implanted defibrillators to surgery.
- Our experienced heart surgeons and interventional cardiologists perform procedures to remove an obstruction that may result from the thickening of your heart muscle or treat problems of the mitral valve.
- Specialized treatment is available to pregnant women with hypertrophic cardiomyopathy. Our maternal-fetal medicine experts help women manage cardiac issues during pregnancy.
If hypertrophic cardiomyopathy is suspected, a thorough history and physical exam will be performed and diagnostic tests may be ordered, including one or more of the following.
An ultrasound of the heart creates images that allow doctors to see your heart’s structure.
Performed on a treadmill, this test evaluates how efficiently your heart works during exercise.
A battery-operated, portable device records your heart’s electrical signal for days or weeks to determine if you have abnormal heart rhythms.
This sophisticated imaging technology uses magnetic energy to create images of your heart. It provides important information about the size and thickness of your heart muscle. It can also reveal scarring on your heart muscle, which may lead to abnormal heart rhythms.
Genetic testing in the form of a blood test can determine if you carry a gene linked to hypertrophic cardiomyopathy. If you do, there is a 50 percent chance that the gene will be passed on to your children. Our genetic counselors help family members learn about genetic testing and how to reduce their risk of heart disease.
Your treatment is based solely on your unique condition. It may include one or more of the following options.
May be prescribed to manage arrhythmias, lower your blood pressure, and improve blood flow to the heart.
If you are diagnosed with a life-threatening arrhythmia or have other risk factors, a battery-powered implantable cardioverter defibrillator (ICD) may be implanted under your skin. Thin wires placed within or near your heart muscle will continuously monitor your heart rhythm and may shock the heart back into rhythm if a life-threatening heart rhythm develops. This device offers a high level of protection against unpredictable heart rhythm abnormalities but does require routine monitoring.
Open heart surgery may be recommended if the muscular wall that separates the right and left sides of the heart -- called the septum -- thickens and bulges. This can restrict the heart’s ability to pump blood effectively out of the left ventricle to the body. During this procedure, a portion of the thickened septum is removed to relieve an obstruction. This procedure is used when medication alone isn’t effective to reduce severe symptoms such as shortness of breath that limits activity.
When the thickening of your heart’s septum occurs in a small, defined area, our interventional cardiologists may use a catheter procedure to inject alcohol into the area. This leads to thinning of the muscle and fewer symptoms over a few months. This procedure is less invasive than myectomy and may be a good option for older patients who have other medical problems.
Heart disease that has progressed to heart failure may require a heart transplant. The transplant program at Duke is one of the nation’s largest and has been named one of the highest performing heart transplant centers in the country by the U.S. Department of Health and Human Services.