What are the complications of hypertrophic cardiomyopathy?

103
HME Billing

Hypertrophic cardiomyopathy or HCM is a complex disease of the heart in which the heart tissue becomes abnormally thickened—particularly the ventricular tissue. Most patients of HCM lead a normal life with little or no symptoms. In a small percentage, however, there are complaints of abnormal heart rhythms, chest pain and shortness of breath. These symptoms need prompt evaluation by Internal Medicine specialist in Lahore to make the diagnosis of hypertrophic cardiomyopathy.

Symptoms

Chest pain: during exercise or periods of exertion as the oxygen demand of the tissues increases, the heart strains to meet this demand and beats faster. This added strain can in turn lead to chest pain or pressure.

Fatigue: patients of HCM struggle with fatigue everyday and are advised not to exert themselves.

Palpitations: are a result of arrhythmias or irregular heart rhythm. Abnormalities in the rhythm may be due to atrial or ventricular fibrillation.

Shortness of breath: dyspnea or shortness of breath is secondary to exertion as there is decreased outflow of blood from the heart and insufficient oxygen for working tissues.

Fainting spells: may be a consequence of irregular heart beat—arrhythmias or due to the abnormal response of the blood vessels during exercise.

Sudden death: in a small number of patients, sudden cardiac death may result.

Complications of HCM include:

Atrial fibrillation

Arrhythmias such as atrial or ventricular fibrillation result from the abnormalities in the conduction or the electrical system of the heart. When the heart muscle thickens, it changes the conductivity as well, predisposing the heart to arrhythmias and abnormalities in conduction. Atrial fibrillation predisposes the patient to stroke due to clot development, as well as, palpitations and fainting spells.

Mitral valve disorders

Valvular disorders result when the heart muscle hypertrophies or enlarges, leading to difficulty in closure of the valve between the left atrium and the ventricle. As a result, there is backflow of the blood from the ventricles back into the atrium worsening the symptoms of the disease, and decreasing the cardiac output. The backflow also puts undue pressure on the left atrium, and inclines the patient to clot formation due to stasis.

Heart failure

Down the road, the heart muscle stiffens so much that it fails to pump the blood. In this state, the cardiac output is insufficient to meet the demand of the body, and cardiac failure ensues. Without prompt treatment, the other organs are affected.

Blocked blood flow

In HCM, the diastolic or filling function of the heart is affected. It is during this filling phase, when the blood vessels of the heart muscle, or the coronary vessels get replenished. Consequently, blood supply to the coronary vessels is impeded, making heart attack more likely.

Likewise, the blood leaving the heart is also blocked due to the hypertrophied cardiac tissue. This in turn, causes chest pain on exertion, difficulty in breathing, fainting spells and dizziness.

Sudden cardiac death

Sudden cardiac death secondary to hypertrophic cardiomyopathy is seen in a small percentage of patients. Sudden cardiac death may occur at any age due to HCM, affecting both genders, all ethnicities and even well-trained athletes, equally.

Despite the advances in medical science, it is difficult for healthcare providers to diagnose a patient at risk of sudden cardiac death. It is hypothesized that in patients of HCM, sudden cardiac death may be a consequence of obstruction of the left ventricular outflow tract due to septal thickening.

People who are at higher risk of sudden cardiac death include young HCM patients with history of fainting spells, those with abnormal blood pressures, and those with arrythmias. Such patients need careful evaluation and regular check-ups from certified cardiologists, bookings for which are available at oladoc.com.