Dr. M.J. Bazos, MD Patient Handout

CARDIOMYOPATHY,

HYPERTROPHIC

About Your Diagnosis
Cardiomyopathy is a disease of the heart muscle that prevents the muscle from generating the normal force of contraction. The result is that the heart does not effectively pump blood. Hypertrophic refers to the muscle thickening that occurs in the ventricle. The thickening may occur in the entire left ventricle or only in the portion of the ventricle called the septum (the area between the two sides of the heart near where the blood exits the ventricle). A thickened septum eventually grows too large and affects the flow of blood from the ventricle. The thickened muscle usually pumps well but does not fill well. It may become stiff and lead to inefficient pumping of blood to the body. This inefficient pumping of blood is heart failure. Because the outflow of blood is compromised, a person with severe hypertrophic cardiomyopathy is at risk for syncope (fainting), angina (chest pain), dyspnea
(difficulty breathing), and sudden cardiac death. Hypertrophic cardiomyopathy usually is caused by genetic inheritance of the condition. It also may occur among elderly persons with long-standing untreated hypertension (high blood pressure).

Living With Your Diagnosis
Most persons with this condition experience fatigue, decreased ability to exercise, or chest pain. With heart failure, there may be swelling in the legs or feet or shortness of breath. There can be palpitations (feeling of the heart beating too fast) from an arrhythmia (abnormal heart rhythm). Symptoms lead to an examination that usually demonstrates an abnormal electrocardiogram (ECG) and a heart that looks enlarged on a chest radiograph (x-ray). The examination may reveal a heart murmur (abnormal sounds in the heart) and usually shows signs of an enlarged heart and heart failure. Echocardiography (an ultrasound examination of the heart) or angiography (radiographic examination performed to assess blood flow through the heart) is used to assess the structure of the heart muscle and the pumping function of the heart.

Treatment
Therapy for cardiomyopathy is aimed at reducing excessive ventricular contraction and addressing the symptoms of heart failure and arrhythmia. If the cause of cardiomyopathy is known, the patient is treated for that condition. If there is heart valve damage, antibiotics are prescribed for use before and after dental or surgical procedures to prevent infection of the heart muscle. Antiarrhythmic medications are prescribed. Medications that decrease heart rate and the strength of contractions may be prescribed. These includes beta-blocker (propranolol) or calcium channel blocking (verapamil) medicines. If pumping function is seriously decreased and the symptoms worsen, a pacemaker may be needed.

The DOs
•Take all medications as prescribed.

The DON’Ts
•Do not exercise unless you have clearance from your physician, even if you have no symptoms.

When to Call Your Doctor
•If you have new or worsening chest pain, shortness of breath, swelling in the legs, or fainting.