The Scripps Clinic Hypertrophic Cardiomyopathy Program has been designated as a Center of Excellence by the Hypertrophic Cardiomyopathy Association. Learn about types of cardiomyopathy and how it’s treated at our nationally recognized program. Please call 858-824-2018 to reach our hypertrophic cardiomyopathy program.
Cardiomyopathy is a heart disease in which the heart muscle becomes weakened, stretched or has another structural problem. It often occurs when the heart cannot pump or function well.
Detection and diagnosis of cardiomyopathy may include:
- Physical exam and blood tests
- Electrocardiogram (EKG)
- Chest X-ray
- Exercise stress test (also known as treadmill test)
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Radionuclide studies
- Cardiac catheterization (coronary angiogram)
There are two main types of cardiomyopathy — hypertrophic cardiomyopathy and dilated cardiomyopathy. Learn more about the causes, diagnosis and treatment of each type.
Hypertrophic cardiomyopathy (HCM) is a genetic condition in which the heart muscle is thick. It potentially results in an inability to pump blood efficiently, especially during exercise. The result can be dizziness and fainting.
Due to scarring in the heart muscle, some patients may develop a dangerous cardiac arrhythmia known as ventricular tachycardia. Besides dizziness and possible fainting, other symptoms of hypertrophic cardiomyopathy may include chest tightness, shortness of breath and a sensation that the heart is racing. Hypertrophic cardiomyopathy can also result in sudden cardiac death.
Hypertrophic cardiomyopathy is detected and diagnosed by a non-invasive test called an echocardiogram (EKG) where an ultrasound machine records pictures of the heart’s structure and motion. The test may be performed before and after you exercise on a treadmill to see how your heart responds to physical effort.
In addition to the stress test, you may be asked to wear a heart monitor (also known as mobile telemetry or event monitor) that continuously records your heart’s electrical activity over several days or weeks. If you have symptoms or the device detects an abnormal heart rhythm, such as a dangerous ventricular tachycardia, your doctor will be notified and can review your heart monitor’s recordings remotely to get a diagnosis.
You may also be asked to provide a blood sample so your genes can be screened for inherited abnormalities.
Hypertrophic cardiomyopathy treatment may include:
- Beta blockers, which slow heart rate, lower blood pressure and control angina (a type of chest pain caused by reduced blood flow to the heart)
- Calcium channel blockers, which relax blood vessels and increase the supply of blood and oxygen to the heart, while reducing its workload
- Disopyramide, which works by decreasing LVOT (left ventricular outflow tract obstruction), which is a hallmark of the disease
- Septal myectomy is when the surgeon removes a small amount of the thickened septal wall to widen the outflow tract from the left ventricle to the aorta.
- Implantable cardioverter defibrillator (ICD) keeps the heart beating at a healthy rate. The ICD is implanted under the skin and delivers a shock to stop abnormal heart rhythms, which are common with this disease.
- Alcohol septal ablation is a less-invasive surgical treatment that reduces the obstruction of blood flow out of the heart. This procedure is performed through a small incision at the top of the leg.
Dilated cardiomyopathy (DCM) is a cardiac condition where the heart muscle becomes weakened because its main pumping chamber, the left ventricle, is enlarged and dilated. The heart’s other chambers compensate by stretching and increasing the heart’s capacity to pump blood, but they cannot sustain the heart’s imbalance long-term.
As a result, kidneys often retain water and sodium, and if fluid builds up in the legs, ankles, feet, lungs or other organs, the body becomes “congested” (a condition known as congestive heart failure). Other symptoms of cardiomyopathy may include lightheadedness, chest tightness, shortness of breathing and fainting.
Because the precise cause or causes of dilated cardiomyopathy can vary from blocked arteries, viruses, toxic chemicals, genetics or pregnancy, the condition is also called an “idiopathic” cardiomyopathy.
If you have a family member with idiopathic dilated cardiomyopathy, talk with your physician about getting screened and tested for the condition.
Dilated cardiomyopathy is best treated with a multidisciplinary team of physicians, including heart failure physicians, interventional cardiologists and electrophysiologists who specialize in heart muscle function and heart electrical function.
Treatment options include:
- Heart medications to help the heart regain strength, while reducing symptoms of cardiomyopathy
- Implantable cardioverter defibrillator (ICD) to keep the heart beating at a healthy rate, which is implanted under the skin and delivers silent pacing treatment or a shock to stop abnormal heart rhythms
- Cardiac resynchronization therapy (CRT) to increase the heart’s pumping efficiency
Scripps heart physicians are international leaders in the development of ICD and CRT therapy.
Scripps heart specialists also treat the following types of cardiomyopathy:
- Restrictive cardiomyopathy
- Ischemic cardiomyopathy
- Peripartum cardiomyopathy