Hypertrophic Cardiomyopathy

Hypertrophic Cardiomyopathy “Cardiomyopathy” is used to describe diseases of the heart muscle, in which the muscle becomes enlarged, thick, or ridged. The main types of cardiomyopathy are dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, and arrythmogenic right ventricular dysplasia. Of these types, hypertrophic cardiomyopathy (HCM) is the second most common form, although it is rare in general. HCM specifically involves the thickness of the myocardium, in which one part of the muscle is thicker than the others. According to the A.D.A.M. Medical Encyclopedia, research on the etiology has led to findings that it is primarily an inherited disease caused by a gene mutation involving the sarcomere proteins in the myocardium, causing defects in heart muscle growth (“Hypertrophic cardiomyopathy,” 2012). It can also develop over time due to hypertension (high blood pressure) or aging. It has been the cause of death of many young athletes, but the
disease can affect people of all ages. However, younger people likely have a more severe form of HCM compared to those affected in other generations. In research conducted by Maron et al. (2000), 750 patients previously diagnosed with HCM were studied to measure mortality rates with different complications of the disease. They found that sudden and unexpected death occurred most often in patients younger than the age of 35, most heart-failure related deaths occurred in middle age, and stroke was seen in only older patients. Epidemiology research shows that HCM is reported in about 0.5% of outpatients referred for echocardiography, and occurs only in 0.5-0.2% of the general population (Shah, 2012). This research also shows that 25% of those with first degree relatives (relatives that share most of the same genes) suffering from the disease also have evidence of HCM. It is also found to occur slightly more in males than in females. Many patients dealing with hypertrophic cardiomyopathy show no symptoms at all and lead normal lives. Some patients may experience shortness of breath, dizziness, chest pain, lightheadedness, and/or fainting. Physical activity is very difficult for those experiencing these symptoms. Heart palpitations may also occur. Diagnosis is followed by a doctor hearing abnormal heart beats or electrocardiogram (ultrasound) scan (Northwestern Memorial Hospital, 2011). The National Heart Lung and Blood Institute (2011) list several different options for treatment as well as prevention of HCM and all types of cardiomyopathy on their website, http://www.nhlbi.nih.gov. Treatment is based on the severity of the patient’s condition, any complications associated with the patient’s health, and age. A low fat, low sodium diet is recommended. Due to the symptoms associated with physical activity, however, individual patients should consult with their doctors for a personalized plan. Patients may be prescribed ACE inhibitors, angiotensin II receptor blockers, beta blockers, calcium channel blockers, antiarrhythmics, and/or anticoagulants to help lower blood pressure, heart rate, and prevent blood clots from forming. Surgery may also be an option. Prevention of HCM requires maintaining a healthy lifestyle, reducing stress, and regularly visiting a doctor. My personal career goal is to become a nurse and eventually go into a family medicine practice as a family physician and/or become a cardiothoracic surgeon. HCM relates to these goals because it can affect people throughout the lifespan, from birth to old age. Knowing the varying signs and symptoms at each age would be beneficial in diagnosing any patient with HCM as a family physician. Because this disease can be devastating, especially to young athletes as seen sometimes in the news who suffer from sudden death due to cardiac arrest, I believe it would be ideal to offer electrocardiogram scans to young athletes with a family history of HCM.
References
How can cardiomyopathy be prevented?
- NHLBI, NIH. (2011, January 1). NIH Heart, Lung and Blood Institute. Retrieved December 3, 2012, from http://www.nhlbi.nih.gov/health/health-topics/topics/cm/prevention.html
Hypertrophic cardiomyography. (2012, July 10). Northwestern Memorial Hospital. Retrieved December 3, 2012, from http://www.nmh.org/nm/heart-failure-hypertrophic-cardiomyopathy Hypertrophic cardiomyography. In A.D.A.M. Medical Encyclopedia. Bethesda : U.S. National Library of Medicine. Retrieved December 2, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001243/
Maron, B., Olivotto, I., Spirito, P., Casey, S., Bellone, P., Gohman, T., et al. (2000). Epidemiology of hypertrophic cardiomyopathy- related death: revisited in a large, non-referral- based patient population. Circulation, 8.
Shah, S. (2012, April 11). Hypertrophic cardiomyography. Medscape Reference. Retrieved December 3, 2012, from
http://emedicine.medscape.com/article/152913-overview#aw2aab6b2b5