Hypertrophic Cardiomyopathy

UT Southwestern Medical Center’s heart specialists expertly diagnose and treat people with hypertrophic cardiomyopathy (HCM), a condition that can lead to irregular heart rhythms and heart failure. 

Combining skill and experience with the newest science-based tools and techniques, our cardiologists and cardiothoracic surgeons evaluate and treat people who have this serious illness. 

What Is Hypertrophic Cardiomyopathy?

Hypertrophic cardiomyopathy (HCM) is a condition in which the heart’s ventricular walls have become excessively thick, making it difficult for the heart to pump out blood. HCM is usually asymmetrical, meaning that one side of the heart is thicker than the other.

Also known as hypertrophic obstructive cardiomyopathy (HOCM) or idiopathic hypertrophic subaortic stenosis (IHSS), it is estimated to affect 1 in 500 people – at least 600,000 – in the U.S.

UT Southwestern is one of four certified Centers of Excellence nationwide and is the first certified center in North Texas. HCMA Centers of Excellence are recognized for providing comprehensive diagnostic, treatment, education, and research programs for HCM.

How Is Hypertrophic Cardiomyopathy Diagnosed?

The first step of a successful treatment plan for a patient with HCM is a timely and appropriate diagnosis.

HCM can present in a wide variety of ways. Many conditions, particularly high blood pressure and intense exercise, can look like HCM but are not.

Our team combines careful clinical history with leading-edge cardiac imaging and genetic testing to confirm the diagnosis of HCM.

UT Southwestern cardiologists might perform several tests to diagnose HCM. Common diagnostic tests include:

• Electrocardiogram (ECG or EKG): To look for evidence of muscle thickening and the presence of abnormal heart rhythms
• Echocardiography (echo or cardiac ultrasound): To evaluate muscle thickness, heart function, and blood flow out of the heart
• Cardiac MRI: To assess the amount of hypertrophy (enlargement) and the degree of scarring, and to differentiate HCM from other related cardiac conditions
• Cardiac catheterization: To assess coronary anatomy and the degree of obstruction
• Genetic screening: To determine if a gene mutation might have caused HCM and potentially use that information to screen at-risk family members

What Are Hypertrophic Cardiomyopathy Symptoms?

Many people with hypertrophic cardiomyopathy experience no symptoms. In those who do, symptoms can include:

• Palpitations from abnormal heart rhythms
• Angina (chest pain)
• Fainting spells (syncope)
• Shortness of breath
• Sudden cardiac death

How Is Hypertrophic Cardiomyopathy Treated?

After completing a comprehensive assessment, our multidisciplinary team can offer personalized treatment based on the patient’s goal and symptoms, including the latest medical therapy.

Treatments include:

• Cardiac myosin inhibitors (CMI): Mavacamten is the first drug to directly target hypertrophic cardiomyopathy and can improve quality of life and exercise capacity. Due to a rare risk of heart dysfunction, these inhibitors are carefully regulated, and at UT Southwestern, we have a multidisciplinary CMI team that helps patients thrive on this new medication while minimizing risks.
• Surgical myectomy: We provide evaluation and patient-oriented discussion of the benefits and risks of surgical myectomy for patients with obstructive HCM.
• Heart transplant: We offer advanced heart failure treatment and evaluation for heart transplantation for patients who are developing end-stage heart failure.

Are recreational exercise and competitive athletics permitted with HCM?

The role of exercise in HCM has changed dramatically over the past 10 years due to research showing exercise is safe and effective for patients with the condition. Some of this cutting-edge research has been performed at UT Southwestern. We can evaluate and counsel any patient with HCM interested in recreational exercise, as well as offer a shared decision-making approach for competitive athletes with confirmed or suspected HCM.

Are patients with HCM at increased risk for arrhythmias and risk of sudden cardiac death?

Patients with HCM can be at risk for abnormal heart rhythms, which can cause symptoms or even death. At UT Southwestern, we thoroughly assess every patient with HCM for their risk of arrhythmias, and we provide evaluation and personalized approaches for patients with or at risk for abnormal heart rhythms. Treatment may include implantable cardioverter defibrillators (ICDs), subcutaneous ICDs (s-ICDs), or anti-arrhythmic medication.

What Support Services Does UT Southwestern Offer?

UT Southwestern’s cardiac rehabilitation specialists create customized plans that integrate proper nutrition, exercise, and, if necessary, nicotine cessation into patients’ lifestyles to improve their cardiovascular health. 

What Clinical Trials Are Available for Hypertrophic Cardiomyopathy?

As one of the nation’s top academic medical centers, UT Southwestern offers a number of clinical trials aimed at improving the outcomes of patients with cardiovascular disease.

Clinical trials often give patients access to leading-edge treatments that are not yet widely available. Eligible patients who choose to participate in one of UT Southwestern’s clinical trials might receive treatments years before they are available to the public.