What is cardiomyopathy ?
Cardiomyopathy is a group of diseases that affect the heart muscles, leading to changes in the structure and functioning of the heart. In some cases, this can affect its ability to pump blood efficiently throughout the body. It can be caused by a variety of factors and affects people of all ages and backgrounds.
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What are the most common cardiomyopathies?
There are several types of cardiomyopathies, each with its own causes and characteristics. All forms of this disease target the heart muscle, making the heart pump less effective. The most common types are hypertrophic cardiomyopathy (HCM), characterised by thickening of the heart muscle, and dilated cardiomyopathy, where the heart stretches and weakens.
What’s happening in a heart with HCM?
The heart is a vital organ that acts as a pump to send blood flowing around the body. Understanding how it works will enable you to be more aware of the signs of your disease.
The right side of the heart receives oxygen-depleted blood from the body through the veins and pumps it to the lungs to absorb oxygen and release carbon dioxide. The left side of the heart receives oxygenated blood from the lungs and pumps it around the body via the arteries. This vital process ensures that the body receives the oxygen it needs to function.
Every day, the heart pumps about 8,000 liters of blood.[2]
To do this, it needs to be well-relaxed so that the chambers can fill properly with blood.
The heart affected by HCM may have difficulty pumping blood through the body
In the case of oHCM, an obstruction of blood flow is observed.
...in the case of hypertrophic cardiomyopathy (HCM) ?
In the case of hypertrophic cardiomyopathy (HCM), the thick, stiff walls of the heart do not allow it to relax properly and fill with blood as it should.
...in the case of obstructive hypertrophic cardiomyopathy (oHCM)?
The problem is mainly in the left ventricle of the heart. Normally, the latter is responsible for propelling oxygenated blood to the rest of the body via the aorta. However, the thickened wall of the heart partially blocks blood flow. The heart must then work harder and use more energy, which can cause symptoms such as shortness of breath, fatigue and chest pain.
1/500
It is estimated that 1 in 500 adults have HCM.[3]
Up to 70% of patients diagnosed have oHCM.[4]
Let’s take a closer look at what’s going on:
oHCM, what should I expect?
Although it can sometimes be completely asymptomatic, the symptoms most often observed in cases of oHCM include shortness of breath, increased fatigue, chest pain, fainting or dizziness and irregular heartbeat. These symptoms can vary from one person to the next.
Frequent symptoms may include:
Shortness of breath
especially during physical activity
Ankle and/or foot swelling
Irregular heartbeat
Chest pain
Dizziness
Fainting
Fatigue
These symptoms can be similar to those of other conditions, only a cardiologist can determine the cause. If you experience any of these symptoms, speak to your doctor. If you feel a sudden, severe change; such as fainting, severe chest pain, or difficulty breathing at rest: seek medical attention immediately.
What are the possible complications?
The extensive research on the treatment of oHCM highlights the importance of the medical support we want to provided to individuals affected by this condition.
Although its impact on health is serious, it is important to note that each case can be managed with care, allowing most people to live relatively normally. Potential complications include heart failure, atrial fibrillation, and more rarely, strokes (cerebrovascular accidents) and sudden cardiac arrest.
Statistics to keep an eye on
Like many chronic heart conditions, HCM can sometimes lead to complications.
The most important ones to be aware of are:
- Heart failure[5]-[6]:
In some people, the heart muscle may gradually become less able to pump effectively.
- Atrial fibrillation (AF)[7]:
An irregular heart rhythm that can cause palpitations and increase the risk of stroke.
- Stroke[8]:
People with HCM, particularly those with AF, have a higher risk of stroke than the general population.
- Sudden cardiac arrest[9]-[10]:
This is rare, but a small number of patients, particularly younger people with specific risk factors, can be at increased risk. This estimate is based on annual rates observed in historical cohorts. Modern risk assessment and ICD implantation have significantly reduced this risk.
Your cardiologist will assess your individual risk profile and adapt your care plan accordingly.
[2] Maron MS, et al. N Engl J Med. 2003;348(4):295-303. DOI 10.1056/NEJMoa021332
[3] Maron MS, et al. N Engl J Med. 2003;348(4):295-303. DOI 10.1056/NEJMoa021332
[4] Maron MS, et al. N Engl J Med. 2003;348(4):295-303. DOI 10.1056/NEJMoa021332
[5] Ho CY, et al. Circulation. 2018;138(14):1387-1398. DOI : 10.1161/CIRCULATIONAHA.117.033200
[6] Luiten RC, et al. Open Heart. 2016;3(2):e000488. DOI : 10.1136/openhrt-2016-000488
[7] Zaiser E, et al. J Patient Rep Outcomes. 2020;4(1 ):102. DOI : 10.1186/s41687-020-00269-8
[8] Ammirati E, et al. EurJ Heart Fail. 2016;18(9):1106-1118. DOI : 10.1002/ejhf.541
[9] Ho CY, et al. Circulation. 2018;138(14):1387-1398. DOI : 10.1161/CIRCULATIONAHA.117.033200
[10] Cox Set al. Heart. 1997;78(2):182-187. DOI : 10.1136/hrt.78.2.182