Cardiac Condition - Hypertrophic Cardiomyopathy (HCM): Underlying Factors and Remedies

Cardiac Condition - Hypertrophic Cardiomyopathy (HCM): Underlying Factors and Remedies

Hypertrophic Cardiomyopathy (HCM) is a heart condition caused by genetic changes affecting the heart muscle. Treatment for this condition varies depending on the type of HCM – obstructive or nonobstructive.

Treatment for Obstructive HCM

Treatment options for obstructive HCM primarily focus on reducing left ventricular outflow tract obstruction and symptoms. The main treatment approaches include:

• Medications: Beta-blockers and calcium channel blockers are first-line treatments to reduce heart rate and improve symptoms. Mavacamten (Camzyos), recently approved by the Food and Drug Administration (FDA) in 2022, is specifically used for symptomatic obstructive HCM [1][4].
• Invasive Procedures:
• Surgical myectomy: Open-heart surgery to remove part of the thickened septal muscle and relieve obstruction.
• Alcohol septal ablation: A catheter-based procedure that injects alcohol into a small artery supplying the thickened septum, causing it to shrink and reduce obstruction [2][3][4].
• Implantable cardioverter-defibrillator (ICD): Recommended for patients with a history or risk of sudden cardiac arrest due to arrhythmias [1][4].

Treatment for Nonobstructive HCM

For nonobstructive HCM, which lacks significant outflow tract obstruction, treatment mainly involves:

• Medications: Beta-blockers and calcium channel blockers to control symptoms such as chest pain and arrhythmias.
• Lifestyle modifications: Avoiding strenuous activity, managing other risk factors, and close monitoring.
• ICD placement: If the patient is at high risk for sudden cardiac death.

Advanced cases (both obstructive and nonobstructive) with severe heart damage may require a heart transplant for patients with end-stage disease and heart failure symptoms refractory to other treatments [3].

It's essential to note that treatment side effects are common and must be monitored, especially with mavacamten and beta-blockers [1]. Risk stratification, including family history and blood pressure response, guides ICD use [4]. Newer therapies and minimally invasive approaches have improved the quality of life for many patients [5].

Many people with HCM experience few or no symptoms, and their life expectancy is as it is for those without the condition. Only in rare cases will the condition produce severe symptoms and complications that may affect a person's life expectancy. The FDA has approved only one medication, mavacamten (Camzyos), for the treatment of obstructive HCM in 2022.

People with HCM have an increased risk of atrial fibrillation, heart failure, sudden cardiac arrest, stroke, and endocarditis. HCM is congenital and heritable, with a 50% chance of being inherited if a biological parent has the condition.

If you notice changes in your heart rhythm or cardiac symptoms that concern you, including shortness of breath, chest pain, rapid or irregular heartbeats, lightheadedness, or fainting, consult a doctor immediately. Doctors recommend a heart-healthy lifestyle for people with HCM but not yet experiencing symptoms, including staying active, eating a heart-healthy diet, maintaining a moderate weight, getting good quality sleep, avoiding tobacco products, and monitoring for other conditions. Medications such as beta-blockers, calcium channel blockers, antiarrhythmics, diuretics can help manage the symptoms of HCM, but they will not treat the condition itself and may cause side effects.

Science plays a crucial role in managing hypertrophic cardiomyopathy (HCM), as evidenced by the approval of mavacamten (Camzyos) by the Food and Drug Administration (FDA) in 2022 for treatment of obstructive HCM. This drug is not only used for symptomatic obstructive HCM but is also a part of the medical-conditions landscape for health-and-wellness and cardiovascular-health. People with nonobstructive HCM, on the other hand, may benefit from other medications such as beta-blockers, lifestyle modifications, and, if necessary, an implantable cardioverter-defibrillator (ICD) for managing arrhythmias and reducing the risk of sudden cardiac arrest.

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