What is Hypertrophic Cardiomyopathy (HCM)?
Hypertrophic cardiomyopathy (HCM) is a genetic heart disease characterized by thickened heart muscle that can obstruct blood flow and cause serious complications, including sudden cardiac death—especially in young athletes. Affecting about 1 in 500 people, HCM is often underdiagnosed, particularly in Black communities. With early detection and appropriate management, people with HCM can live full, healthy lives.
What are the symptoms of HCM?
Many people with HCM may not experience symptoms. When symptoms do occur, they can include:
Shortness of breath, especially during exercise
Fatigue
Dizziness or fainting
Heart palpitations (fluttering or rapid heartbeat)
It's important to note that some individuals may show no signs or symptoms before sudden cardiac death.
What causes HCM?
HCM is usually caused by mutations in certain genes related to heart muscle proteins. These genetic mutations can run in families.
Are African Americans at higher risk for HCM?
HCM is a relatively common condition that appears to be about twice as common in Black as in White Americans. It affects about 1 in 500 people in the U.S. of all genders, races, and ethnicities. It is often diagnosed in adolescence or young adulthood but can start at any age.
In young athletes, HCM is the leading cause of “sudden cardiac death,” when the heart stops suddenly, leading to death quickly. This disproportionately affects Black athletes involved in high-intensity, competitive sports like football or basketball.
How is HCM diagnosed?
Doctors use several tests to diagnose HCM, including:
Stress testing: Walking or running on a treadmill or riding a stationary bike while hooked up to machines that monitor heart function.
Echocardiogram: Uses sound waves (ultrasound) to provide information about the heart’s thickness and function.
Electrocardiogram (ECG): Measures the heart's electrical activity.
MRI: Provides detailed images of the heart's structure.
Genetic Testing: Identifies mutations associated with HCM.
Early detection is crucial, especially for those with a family history of the condition.
Can HCM be treated?
Yes, treatment options aim to relieve symptoms, prevent complications, and improve the patient’s quality of life:
Medications: Beta-blockers, calcium channel blockers, and newer cardiac myosin inhibitors can help relax the heart muscle.
Procedures: In some cases, surgical options like septal myectomy or alcohol septal ablation may be recommended to remove or shrink the thickened heart tissue.
Implantable Cardioverter-Defibrillator (ICD): For those at risk of sudden cardiac death, an ICD can be implanted to monitor and correct dangerous heart rhythms.
All the different kinds of intervention can increase survival, so it is important to know your situation.
Is it safe to exercise with HCM?
Generally, yes. Regular exercise is essential to overall heart health. For people with HCM, it's important to consult with a healthcare provider to determine the safest levels of exercise. You may have to complete a “stress test” to determine tolerance of different exercise intensity levels.
It’s important to note that certain high-intensity sports may increase the risk of sudden cardiac events, especially in young athletes. For that reason anyone with HCM or a family history of HCM should consult with an HCM expert who can guide decisions about high-intensity and/or competitive athletics.
Should family members be tested for HCM?
Yes, because HCM is often inherited, it's advisable for close family members (parents, siblings, and children) to undergo screening to see if they may be at risk for the condition. This can include genetic testing and cardiac evaluations to detect HCM early before serious symptoms or complications develop.
How can African Americans reduce their risk of complications from HCM?
As with any condition, awareness and proactive management are key. For anyone diagnosed with or at risk of HCM, this generally means:
Regular Check-ups: Attend regular medical appointments to monitor heart health
Know Your Family History: Inform your doctor about any relatives with heart conditions.
Adhere to Treatment Plans: Follow prescribed treatments and medications.
Stay Informed: Educate yourself about HCM and its implications.
Community initiatives, such as health screenings at historically black colleges and universities, aim to raise awareness and provide resources for early detection and management.
