The Treatment Options to Live Better With Hypertrophic Cardiomyopathy

If you have hypertrophic cardiomyopathy (HCM), you may or may not have symptoms. Dizziness and shortness of breath may be tough to live with, especially if you enjoy being active. 

If you have HCM — even if you don’t have symptoms — you’re at an increased risk of sudden cardiac arrest. This may be stressful and scary, and you may have a lot of anxiety about this possibility.

Treatments for HCM can help with all of these concerns. Treatment may help:

• Manage symptoms

• Reduce tissue thickness in the heart

• Reduce the risk of complications (including sudden cardiac arrest)

• Empower you to feel more in control of your health

What medications can help manage hypertrophic cardiomyopathy symptoms?

Two common medication classes that can help treat HCM symptoms are beta blockers and calcium channel blockers. These medications are common treatments for high blood pressure. For HCM, they may help relax the heart and slow the heart rate. This may help give the heart chamber more time to fill with blood between each beat.

Two other medication classes that may be used for HCM include antiarrhythmic medications and diuretics. Antiarrhythmic medications help regulate the heartbeat. They may be useful for people with arrhythmias (abnormal heartbeats), which can increase the risk of cardiac arrest. Diuretics may help some people who struggle with fluid buildup from HCM.

What are new treatment options for hypertrophic cardiomyopathy?

An evolving treatment option for hypertrophic cardiomyopathy is a medication class known as cardiac myosin inhibitors. These work directly in the cells of the heart muscle. These may help the heart to not squeeze as hard during each pump. 

Early data suggest these new medications could also help reduce obstructions caused by excess tissue. These studies are small, so more research is needed. If cardiac myosin inhibitors can help reduce excess tissue growth, it may help treat the underlying cause — instead of just treating symptoms.

What are procedures to treat hypertrophic cardiomyopathy?

Some people may not find relief from medications alone. For this subset of people with HCM, procedures may be an option.

There are at least two main procedures to treat HCM:

• Surgical myectomy: This is a type of heart surgery where the surgeon goes into the heart and shaves off the thickened tissue. This may instantly reduce the blockage.

• Alcohol septal ablation: This is a less invasive procedure. Using catheters, the doctor injects a small amount of alcohol into a specific part of the heart. This shrinks that part of the heart, relieving the obstruction.

How does lifestyle play a role in managing hypertrophic cardiomyopathy?

Your doctor will discuss possible lifestyle changes that can help you minimize symptoms and your risk of complications. Notably, this may include avoiding certain types of exercise and other intense activities.

“Being faced with the diagnosis of hypertrophic cardiomyopathy might seem scary, but I do want to emphasize that this is a very treatable condition,” says Sirish Vullaganti, MD, Cardiologist at Northwell Health. “That's why it's really important to talk to your doctor to make sure you're getting the most up-to-date treatment for this condition.”