Hypertrophic cardiomyopathy

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Complications

By Mayo Clinic staff

Hypertrophic cardiomyopathy occurs in about one in every 500 people and affects men and women equally.

In many people, hypertrophic cardiomyopathy does not cause significant health problems. However, in some people, hypertrophic cardiomyopathy can cause severe signs and symptoms, such as shortness of breath, chest pain or fainting.

People with hypertrophic cardiomyopathy are at risk of dangerous abnormal heart rhythms (arrhythmias), such as ventricular tachycardia or ventricular fibrillation. These abnormal heart rhythms can cause sudden cardiac death. Hypertrophic cardiomyopathy is the leading cause of heart-related sudden death in people under 30. Fortunately, such deaths are rare.

Possible complications of hypertrophic cardiomyopathy include:

  • Arrhythmias. Thickened heart muscle, as well as the abnormal structure of heart cells (disarray), can disrupt the normal functioning of the heart's electrical system, resulting in fast or irregular heartbeats. Atrial fibrillation, ventricular tachycardia and ventricular fibrillation are among the arrhythmias that may be caused by hypertrophic cardiomyopathy.

    The most dreaded complication of hypertrophic cardiomyopathy is sudden cardiac death due to ventricular tachycardia or ventricular fibrillation. Unfortunately, it can be difficult to predict which people with hypertrophic cardiomyopathy are most prone to these life-threatening, abnormal heart rhythms. If you experience fainting spells, extreme dizziness or prolonged palpitations, you should seek immediate medical care.

  • Obstructed blood flow. In many people, the thickened heart muscle causes obstruction to blood flow leaving the heart. This can lead to shortness of breath with exertion, chest pain, dizziness and fainting spells.
  • Mitral valve problems. The thickened heart muscle can leave a smaller space for blood to flow, which in turn causes blood to rush through your heart valves more quickly and more forcefully. This increased force can prevent your mitral valve — the valve between your heart's left atrium and left ventricle — from closing properly. As a result, blood can leak backward into the left atrium. This is called mitral valve regurgitation. Mitral valve regurgitation can lead to other complications, such as heart failure or arrhythmias.
  • Heart failure. Heart failure means your heart can't pump enough blood to meet your body's needs. The thickened heart muscle of hypertrophic cardiomyopathy can eventually become too stiff to fill effectively and can lead to shortness of breath and heart failure.
  • Dilated cardiomyopathy. Over time, thickened heart muscle may become weak and ineffective and the ventricle becomes enlarged (dilated) and its pumping ability becomes less forceful.
References
  1. Cardiomyopathy. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4468. Accessed Jan. 20, 2009.
  2. Maron BJ. Hypertrophic cardiomyopathy. In: Libby P, et al, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/117866989-4/796148825/1549/451.html#4-u1.0-B978-1-4160-4106-1..50068-6_7427. Accessed Jan. 20, 2009.
  3. Elliot P, et al. Clinical manifestations of hypertrophic cardiomyopathy. http://www.uptodate.com/home/index.html. Accessed Jan. 20, 2009.
  4. Hypertrophic cardiomyopathy. The Merck Manuals Online Medical Library: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec07/ch084666/ch084666c.html. Accessed Jan. 20, 2009.
  5. Ferri F. Cardiomyopathy, hypertrophic. In: Ferri FF. Ferri's Clinical Advisor 2009. St. Louis, Mo.: Mosby; 2008:162.
  6. You JJ, et al. Life expectancy gains and cost-effectiveness of implantable cardioverter/defibrillators for the primary prevention of sudden cardiac death in patients with hypertrophic cardiomyopathy. American Heart Journal. 2007;154:899.
  7. Pigozzi F, et al. Sudden death in competitive athletes. Clinics in Sports Medicine. 2008;27:153.
  8. Maron BJ. Hypertrophic dardiomyopathy and other causes of sudden cardiac death in young competitive athletes, with considerations for preparticipation screening and criteria for disqualification. Cardiology Clinics. 2007;25:399.
  9. Ingles J. Psychosocial impact of specialized cardiac genetic clinics for hypertrophic cardiomyopathy. Genetics in Medicine. 2008;10:117.
  10. Morgan JF, et al. Psychiatric disorders in hypertrophic cardiomyopathy. General Hospital Psychiatry. 2008;30:49.

DS00948

March 25, 2009

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