Hypertrophic cardiomyopathy - diagnosis and treatment

Note: This content was written before the COVID-19 pandemic, and does not explain appropriate pandemic protocols. 

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Hypertrophic cardiomyopathy - diagnosis and treatment

Your doctor will examine you and ask you questions about signs and symptoms, and medical and family history.


Your doctor may order tests to diagnose hypertrophic cardiomyopathy or rule out other conditions that can cause similar symptoms.

Echocardiogram. An echocardiogram is commonly used to diagnose hypertrophic cardiomyopathy. 

This test uses ultrasound imaging to see if the heart muscle is abnormally enlarged. It also shows how well the heart's chambers and valves pump blood.

Electrocardiogram. Sensors (electrodes) attached to patches are placed on the chest and sometimes on the legs to measure electrical signals from the heart. 

An ECG can show an irregular heartbeat and signs of an enlarged heart muscle.

Your doctor may recommend monitoring your heart rate at home. A portable electrocardiogram (Holter device) can be worn for one or more days to record your heart's activity during daily activities.

Cardiac magnetic resonance imaging. This test uses strong magnetic fields and radio waves to take pictures of your heart. 

It also provides information about the health of the heart muscle and how well the heart and its valves work. This test is often done with an echocardiogram.

voltage test. The stress test often involves walking on a treadmill or riding a stationary bike while the heart is monitored. 

Exercise stress tests help reveal the nature of the heart's response to physical activities.


Treatment for hypertrophic cardiomyopathy aims to relieve symptoms and prevent sudden cardiac arrest in people at high risk of developing it. Treatment depends on how severe the symptoms are. 

Your doctor will discuss with you to determine the most appropriate treatment for your condition.

But if you have cardiomyopathy and you're pregnant or about to become pregnant, your doctor may recommend a doctor who specializes in caring for women with high-risk pregnancies (perinatal or maternal-fetal medicine specialist).


Medications can help reduce the force of your heart's contraction and slow it down so it can pump blood better. 

Medications used to treat hypertrophic cardiomyopathy and its symptoms may include:

Beta-blockers such as metoprolol (Lopressor, Toprol-XL), propranolol (Inderal, Innopran XL), or atenolol (Tenormin)

Calcium channel blockers, such as verapamil (Verelan, Calan SR) or diltiazem (Cardizem, Tiazac)

Arrhythmia medications, such as amiodarone (Pacerone) or disopyramide (Norpace)

Anticoagulants, such as warfarin (Jantoven), dabigatran (Pradaxa), rivaroxaban (Xarelto), or apixaban (Eliquis) to prevent blood clots if you have atrial fibrillation or the apical type of hypertrophic cardiomyopathy, which may increase your risk of sudden cardiac arrest.

Surgeries or other procedures

Many surgical procedures or procedures can be used to treat cardiomyopathy or its symptoms. Such as:

Septal muscle resection. This open-heart surgery may be recommended if medications don't relieve symptoms. 

This surgery involves removing part of the thick, enlarged wall (septum) separating the heart's chambers. 

A septal myotomy helps improve blood flow out of the heart and decreases the reverse flow of blood through the mitral valve (mitral regurgitation).

The surgery can be performed using different methods based on the location of the hypertrophy in the heart muscle. 

In one type of surgery called an apical myectomy, surgeons remove the enlarged portion of the heart muscle near the apex of the heart. Sometimes the mitral valve is repaired at the same time.

Septal excision. This procedure destroys the enlarged heart muscle with alcohol. Alcohol is injected through a long, thin tube (catheter) into the artery that supplies blood to this area. 

Possible complications include a defect in the heart's electrical system (cardiac embolism), which requires the implantation of a pacemaker.

An implantable cardioverter-defibrillator. An implantable cardioverter-defibrillator is a small device that continuously monitors your heartbeat. 

It is implanted in the chest like a pacemaker. If a potentially life-threatening arrhythmia occurs, an ICD delivers micro-calibrated electrical shocks to restore the heart's normal rhythm. 

The use of an ICD has been shown to help prevent sudden cardiac death, which occurs in a small number of people with hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy and treatment options

Lifestyle and home remedies

Lifestyle changes, such as the following, can reduce your risk of complications related to hypertrophic cardiomyopathy.

Playing sports. You can probably do moderate-intensity exercise as part of your healthy lifestyle. 

And if you want to do more vigorous exercise, talk to your doctor about the potential risks.

Follow a healthy diet. A healthy diet should be followed as it is an important part of maintaining a healthy heart.

Maintain a healthy weight. Maintaining a healthy weight should prevent excessive strain on your heart and reduce health risks associated with surgery or other procedures.

Limit or avoid alcohol. In some cases, drinking alcohol may contribute to arrhythmia, blocking blood flow, or worsening these conditions. Ask the doctor  About the amount of alcohol that is safe to drink. 

If you decide to drink alcohol, drink it in moderation. For healthy adults, this means one serving per day for women and two servings per day for men.

Regular medical appointments. Your doctor may recommend regular follow-up appointments to assess your condition. Tell your doctor if you develop any new or worsening symptoms.

Adaptation and support

Being diagnosed with hypertrophic cardiomyopathy can lead to a range of difficult emotional outbursts. It is not excluded that you feel sadness, fear, and anger.

To better control your condition, do the following:

Control the tension. Try to find ways to reduce tension and stress. One of the ways to reduce stress is to exercise more often and practice mental focus.

Ask for support. Consider joining a support group. Support groups allow you to connect with others who are going through similar experiences.

Prepare for your appointment

You'll likely be referred to a doctor trained in diagnosing and treating heart conditions (cardiologist). Here's some information to help you get ready for your appointment.

What you can do

When you book an appointment, ask about any restrictions you should follow before the appointment, such as changing your activity level or diet. Write a list of the following:

Your symptoms and when they began

All medications, vitamins, and supplements you take, including dosages

Key medical information, including other diagnosed conditions and family history of heart disease

Questions you would like to ask the doctor

Questions you may want to ask your doctor may include:

What is the most likely cause of these symptoms?

What tests do I need to take?

What treatments might help me?

What are the potential risks of my heart condition?

How often should I have follow-up appointments?

Will I need to limit my activity?

Should my children or first-degree relatives be tested for this disease, and should I go to a genetic counselor?

How will other diseases I have or other medications I take affect my heart disease?

Feel free to ask any other questions that concern you.

What do you expect from your doctor?

Your doctor is likely to ask you several questions, such as:

How severe are your symptoms?

Have your symptoms changed over time? If so, how?

Does exercise or physical exertion make your symptoms worse?

Have you ever fainted?

What can you do in the meantime?

Before your appointment, ask your family members if any of your relatives have been diagnosed with hypertrophic cardiomyopathy or have experienced sudden, unexplained death.

If exercise aggravates your symptoms, avoid strenuous exercise until your doctor has examined you and given exercise recommendations.

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