Enlarged heart condition: Symptoms, remedies, and further details

Treatment Options for Obstructive Hypertrophic Cardiomyopathy

Enlarged heart condition: Symptoms, remedies, and further details

Obstructive hypertrophic cardiomyopathy (HOCM) is a condition characterized by thickening of the heart muscle, which can lead to obstruction of the left ventricular outflow tract (LVOT). This obstruction can cause symptoms such as shortness of breath, chest pain, and dizziness. Treatment options for HOCM have evolved significantly, with a focus on reducing symptoms and preventing complications.

Medical Management

1. Beta Blockers: These are often the first-line treatment for HOCM. They help reduce the heart rate and contractility, which may alleviate symptoms by reducing the obstruction in the LVOT [3].
2. Verapamil: If beta blockers are ineffective or not tolerated, verapamil can be used as an alternative. It is a calcium channel blocker that can help relax the heart muscle [3].
3. Disopyramide: This medication is added if symptoms persist and the drug is well-tolerated by the patient. It is particularly useful in reducing LVOT obstruction [3].

Surgical and Minimally Invasive Interventions

1. Traditional Septal Myectomy: This surgical procedure involves removing part of the thickened septal wall to relieve the obstruction. Although effective, it requires cardiopulmonary bypass and can be associated with significant trauma [1].
2. Transapical Beating-Heart Septal Myectomy: This minimally invasive technique uses transesophageal echocardiography guidance to precisely remove hypertrophic tissue without needing cardiopulmonary bypass. It offers a less traumatic alternative with real-time assessment capabilities [1].
3. Percutaneous Endocardial Septal Radiofrequency Ablation (PESA): This procedure uses radiofrequency ablation to reduce the thickness of the septum, offering another minimally invasive option for treating HOCM [2].

Pharmacological Innovations

1. Mavacamten (Camzyos): This drug is a fast troponin modulator that has shown promise in reducing LVOT obstruction in symptomatic patients with obstructive HOCM. It acts by decreasing the force of heart muscle contraction, thus reducing the obstruction and alleviating symptoms [4].
2. Aficamten: Another fast troponin modulator, aficamten is currently under review for the treatment of obstructive HOCM. It is expected to offer similar benefits to mavacamten by reducing the contractility of the heart muscle [5].

In summary, the treatment of obstructive hypertrophic cardiomyopathy involves a combination of medical management, surgical interventions, and innovative pharmacological approaches like mavacamten (Camzyos). Each patient's treatment plan is tailored based on their specific symptoms and response to therapy.

• In most cases, HCM follows an autosomal dominant inheritance pattern, meaning that a person needs only one copy of an affected gene to be at risk for the condition.
• In many cases, muscle thickening begins by age 30, but symptoms may not be present or may be mild for several years or decades.
• In rare but serious cases, a heart transplant may be necessary.
• In April 2022, the FDA approved the first HCM-specific medication for the treatment of symptomatic obstructive HCM.
• HCM is not preventable if a genetic mutation is already present, but proactive screening and management can help people reduce the signs and symptoms of HCM.
• There are two types of HCM: obstructive and nonobstructive.
• Medications such as beta-blockers, calcium channel blockers, antiarrhythmic medications, diuretics, and anticoagulants are commonly used in HCM treatment.
• In a study of 653 people with HCM, the annual rates of heart-related deaths were 0.6% for sudden heart-related death, 0.2% for heart failure-related death, and 0.1% for stroke-related death.
• Complications of HCM include heart failure, arrhythmias, blood clots, stroke, infection of the heart valves, and sudden cardiac death in rare cases.
• The primary risk factor for HCM is a family history of heart disease, with nearly 90% of people with HCM having a first-degree family relative who also develops the condition.
• An enlarged muscle wall can also take up more space in the left ventricle, reducing the volume of blood that the heart can push out with each beat.
• Common symptoms include shortness of breath, chest pain, fainting, dizziness, palpitations, excessive tiredness, swelling in the abdomen, legs, ankles, or feet, and sudden death.
• Most people with HCM can expect to live typical, uninterrupted lives with the condition, with the risk of heart-related death being low.
• In most cases, people with HCM can expect to have a typical life expectancy with regular monitoring and preventive treatment.
• Hypertrophic cardiomyopathy (HCM) is a genetic condition that results in the thickening of the muscle walls in the left ventricle of the heart.
• The symptoms of HCM vary considerably from person to person and may not start until later in life.
• HCM is a genetic condition, and environment and lifestyle do not appear to play a role in the development of the condition.
• In HCM, muscles in the walls of the heart may become stiff, making it more difficult for the heart to pump blood throughout the body.
• The risk of symptoms of HCM increases with age, with muscle thickening often beginning early in life but symptoms not appearing for several decades.
• Various procedures are available to help improve heart function and blood flow within the heart, such as repairing the structure of the heart and removing obstructions to blood flow.
• HCM is a progressive disease, and symptoms may appear or become worse over time.
• Obstructive HCM is the more common type, affecting up to 75% of people with HCM.
• The primary goal of treatment for most people with HCM is symptom management and prevention of other heart complications.
• If a person has a family history of HCM or heart disease, they may consider genetic testing and counseling with a licensed genetic counselor for family planning.
• Obstructive HCM occurs when the muscles below the aortic valve become thickened, blocking or reducing blood flow out of the left ventricle and into the aorta.
• People with HCM may also be at risk for complications in other conditions that put strain on the heart, such as pregnancy.
• More recent studies using genetic testing and advanced heart imaging techniques suggest that HCM is much more common than previously thought, affecting up to 1 in 200 people.

1. The focus of science in the field of medical-conditions like hypertrophic cardiomyopathy (HCM) has increasingly turned towards understanding chronic diseases such as other heart diseases and aging.
2. Mental health and wellness are crucial components of overall health, especially for individuals living with long-term health-and-wellness challenges like chronic diseases, such as HCM.
3. Engaging in fitness-and-exercise regularly can help reduce the symptoms of HCM and improve cardiovascular health, ultimately leading to a healthier lifestyle.
4. The occurrence of obstructive HCM can be exacerbated by sports-betting, as the related stress and increased heart rate may lead to complications in individuals with the condition.
5. The prevalence of HCM in the sports community is significant, with athletes at a higher risk due to the intense physical demands and stress on the heart.
6. Innovations in science and medical care are leading to new treatments and therapies for chronic diseases, including previously uncategorized conditions like HCM, offering hope for those affected by these diseases.

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