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Treatment

Treatment for hypertrophic cardiomyopathy depends on the condition of your heart and the severity of your symptoms. The idea is to decrease stress on the heart and relieve symptoms, particularly problems with mitral valve regurgitation and arrhythmias.

Lifestyle Changes

Certain lifestyle changes are recommended for managing HCM. These may include:

  • Fluid and sodium restrictions. These may be needed if heart failure symptoms are present.
  • Exercise. Most patients with hypertrophic cardiomyopathy are able to participate in noncompetitive aerobic activities. But strenuous exercise should be avoided.

Medications

Medications are often prescribed to treat symptoms and prevent further complications.

  • Beta-blockers and calcium channel blockers may be prescribed to relax the heart muscle, allowing it to fill more efficiently and pump more effectively.
  • Other medications may be prescribed as needed to control your heart rate or decrease the occurrence of arrhythmias.

Septal Myectomy

In this procedure, your surgeon removes a small amount of the thickened septal wall to widen the path the blood takes from the left ventricle to the aorta. Myectomy is considered when medications are not effective in treating HCM. This can eliminate problems with mitral valve regurgitation.

Ethanol Ablation

This procedure is used for patients who are not candidates for septal myectomy. In the procedure, the small coronary artery that supplies blood flow to the upper part of the septum is located during cardiac catheterization. A balloon-tipped catheter is inserted into the artery and inflated. Then, a contrast agent is injected to locate the thickened septal wall that narrows the passageway from the left ventricle to the aorta. Next, a small amount of pure alcohol is injected through the catheter. The alcohol kills the cells, causing the septum to shrink back to a more normal size over time, opening the passage for blood flow.

Implantable Cardioverter Defibrillator (ICD)

These devices are reserved for patients with HCD who are at risk for life-threatening arrhythmias or sudden cardiac death. The ICD is a device placed just under the skin and is connected to wire leads that are threaded through the vein to the heart. An ICD constantly monitors the heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers a shock to the heart muscle to cause the heart to return to beating in a normal rhythm.

Contact Information

Cardiovascular Medicine
Division of the CardioVascular Institute
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215
617-667-8800

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