How to live life to the full despite HCM?
If you have just been diagnosed with hypertrophic cardiomyopathy (HCM), you will probably have many questions and concerns. That’s only natural! How do you live with this disease? How do you look to the future and what is the best way of managing the condition? Although some things may be out of your control, you have the ability to take decisions and make choices that can help you improve your quality of life. You are not alone: about 1 in 500 people suffer from this condition and have had to learn how to manage it and live life to the full regardless.[11]
On this page
Your life is not defined by your illness.
You can choose how to live it despite the difficulties.
Is my quality of life impacted?
HCM can have a significant impact on your quality of life. Symptoms such as shortness of breath, fatigue and chest pain can limit activities of daily living and adversely affect emotional well-being. In addition, the need for regular medical treatment and close monitoring of heart health can trigger stress and anxiety on a daily basis. However, with proper disease management and support, it is possible to improve your quality of life*.
* Improvement in KCCQ-23 Clinical Summary Score at 30 weeks, patient-reported in patients with oHCM NYHA II-III (EXPLORER-HCM)
Exercise and cardiovascular health: best practices to known
Recommendation from the European Society of Cardiology guidelines[12]:
Staying physically active is important for your overall health and wellbeing. Regular exercise can improve physical fitness, reduce fatigue, support mental wellbeing, improve sleep quality and contribute to a better quality of life.
For most people with HCM:
- Regular low‑ to moderate‑intensity physical activity is recommended, as long as you feel able to participate.
- Examples include walking, cycling at a comfortable pace, or light recreational sports.
Physical activity is no longer automatically discouraged for people living with HCM. However, there is no “one-size-fits-all” recommendation. Your activity will depend on your symptoms, your heart (obstructive or non-obstructive HCM) and your individual risk[13].
A personalised approach and shared decision
The choice of physical activity should be made together with your healthcare team and, when appropriate, with specialists experienced in HCM.
Your goals, preferences and lifestyle are important parts of the discussion. If you have questions or would like to adapt your level of activity, do not hesitate to discuss this with your cardiologist.
Exercise safely
It is important to stay aware of how your body responds during exercise. Paying attention to warning signs and following a few simple precautions can help you stay active safely and confidently[14]:
- Stay well hydrated
- Avoid sudden or intense exertion without medical advice
- Discuss any medications or medical conditions that may affect exercise capacity with your doctor
- Attend regular follow-up appointments
What about more intense exercise?
While high-intensity competitive sport is not appropriate for everyone with HCM, it is not automatically ruled out for all patients either. A thorough, individualized evaluation is essential before making any final decision[15]-[16].
Understanding the risks
Heart muscle diseases such as cardiomyopathies are a leading cause of sudden cardiac death during exercise in young people, particularly when the condition is not yet diagnosed.[17]
However:
- The overall risk of serious events is low for many patients
- Regular, appropriate physical activity is generally beneficial
- The goal is to stay active safely, with guidance tailored to your situation
Always consult your cardiologist, who will determine the appropriate level of exercise based on your individual risk level. Regular monitoring is essential in all cases.
Despite a tired heart, I always find the strength to carry on and live each day to the full
Management of HCM, what is the most suitable treatment?[18]
Medicines to treat the symptoms
Medicines are usually the first step in managing HCM. Several types of medication may be used, depending on your individual symptoms and the nature of your condition[19]:
- Medicines that slow the heart rate and reduce its workload (such as beta-blockers or certain calcium channel blockers).
- Medicines that help reduce the obstruction to blood flow in oHCM.
- Cardiac myosin inhibitors that reduce the hypercontractility in oHCM.
- Blood-thinning medicines (anticoagulants), if an irregular heart rhythm (such as atrial fibrillation) is present.
Your cardiologist will discuss all relevant treatment options with you and recommend the approach best suited to your situation.
Medical procedures
Most people with hypertrophic cardiomyopathy (HCM) are treated with medication and regular follow‑up. In some situations, more specialised procedures may be considered.
Septal reduction therapy (including alcohol septal ablation)
In patients with a specific form of HCM, where blood flow out of the heart is obstructed (also called left ventricular outflow tract obstruction, or LVOTO), a procedure to reduce the thickness of the heart muscle (septal reduction therapy) may be considered. This includes options such as alcohol septal ablation or surgery.
However, these treatments are not for everyone. They are usually considered only when:
- You have significant symptoms (such as breathlessness, chest pain, or fatigue)
- AND there is a relevant obstruction to blood flow (a measurable gradient at rest or during exercise)
- AND symptoms persist despite optimal medical treatment
- OR for women of childbearing age who wish to become pregnant
Your cardiology team will carefully assess whether this type of procedure is appropriate for you.
Heart transplantation
Heart transplantation is very rarely needed in HCM. It may be considered only in selected patients who:
- have advanced heart failure or severe limitations in daily life
- continue to have significant symptoms despite all available treatments
This option is only discussed after a thorough evaluation in specialised centres, and only for patients who are eligible for transplantation.
When the defibrillator watches over you
If there is a risk of potentially dangerous disturbances in heart rhythm, your cardiologist may recommend the placement of an implantable cardiac defibrillator (ICD) under the skin.
It is designed to sense when it is needed by delivering an electrical signal to the heart to correct irregular heartbeats. It therefore reduces the risk of serious complications such as sudden cardiac arrest.
Follow-up with your cardiologist
Close monitoring is essential. It allows the cardiologist to monitor the progression of the disease and adjust treatment if necessary. Every patient experiences a unique progression, and through regular follow-ups, the patient and cardiologist can work together to find the best and most appropriate solutions for each situation.
They share their heart story
A few years ago, this 21-year-old patient began experiencing heart palpitations, black spots in her vision, and a loss of strength often at the end of a workday or when climbing stairs. She quickly realized something was wrong and consulted a doctor, who detected a heart murmur. Further tests later confirmed the diagnosis of obstructive hypertrophic cardiomyopathy (HCM).
The diagnosis also shed light on her family history: years earlier, her grandfather had died from a heart condition that was never clearly identified. Only with her diagnosis did the family understand what had been affecting them across generations.
Discover her journey and learn why awareness and family genetic screening can make all the difference.
HCM & Family
Understand heredity, family impact,
and genetic testing options.
Patient experiences
Discover real stories
from people living with HCM.
[11] Arbelo E, et al. ESC Scientific Document Group. 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J. 2023 Oct 1;44(37):3503-3626. DOI : 10.1093/eurheartj/ehad194
[12] Arbelo E, et al. ESC Scientific Document Group. 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J. 2023 Oct 1;44(37):3503-3626. DOI : 10.1093/eurheartj/ehad194
[13] Martens P, et al. Comprehensive evaluation of hypertrophic cardiomyopathy. 2026 Mar 12:xuag035. doi: 10.1093/ejhf/xuag035
[14] Martens P, et al. Comprehensive evaluation of hypertrophic cardiomyopathy. 2026 Mar 12:xuag035. doi: 10.1093/ejhf/xuag035
[15] Arbelo E, et al. ESC Scientific Document Group. 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J. 2023 Oct 1;44(37):3503-3626. DOI : 10.1093/eurheartj/ehad194
[16] Martens P, et al. Comprehensive evaluation of hypertrophic cardiomyopathy. 2026 Mar 12:xuag035. doi: 10.1093/ejhf/xuag035
[17] Zorzi A, Pelliccia A, Corrado D. Inherited cardiomyopathies and sports participation. Neth Heart J. 2018 Mar;26(3):154-165. doi: 10.1007/s12471-018-1079-3.
[18] Arbelo E, et al. ESC Scientific Document Group. 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J. 2023 Oct 1;44(37):3503-3626. DOI : 10.1093/eurheartj/ehad194
[19] Arbelo E, et al. ESC Scientific Document Group. 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J. 2023 Oct 1;44(37):3503-3626. DOI: 10.1093/eurheartj/ehad194
[20] European Heart Journal, Volume 44, Issue 37, 1 October 2023, Pages 3503–3626, https://doi.org/10.1093/eurheartj/ehad194