Are you aware of the thickening of the heart muscle? - Let's talk about Hypertrophic Cardiomyopathy (HCM) in simple terms

Have you ever felt short of breath, a slight pain in your chest, or a slight pain in your chest when walking a short distance or climbing a flight of stairs? Or do you sometimes feel like your heart is beating faster for no reason? Although we think these are normal things, sometimes these can be small signals that our heart is giving us. Today we are going to talk about such a heart-related condition, which many people do not know about, but it is very important to know about. That is Hypertrophic Cardiomyopathy, or (HCM) for short.

Simply put, what is Hypertrophic Cardiomyopathy (HCM)?

This name may sound a bit complicated. Let's break it down for you. The word "hypertrophic" means "larger than normal." "Cardiomyopathy" is a group of conditions that affect the heart muscle, or heart muscle. When you combine the two, Hypertrophic Cardiomyopathy (HCM) means that your heart muscle (heart muscle) becomes thicker than normal .

Imagine that the walls of your house are getting thicker. That means there is less space inside the house, right? The same thing happens to the heart. As the heart muscle thickens, there is less room for blood to fill the heart. This makes it harder for the heart to pump the amount of blood the body needs.

Although this thickening can occur in any part of the heart, it most commonly affects the wall in the middle of the heart. Medically, this is called the septum. When this wall thickens, it can block the flow of blood from the heart's main pumping chamber, the left ventricle, to the aorta, the main blood vessel that carries blood to the body.

This condition is lifelong. It can get a little worse over time. But the best thing is that if diagnosed early and treated properly, complications can be largely prevented .

There are two main types of HCM:

This condition can be divided into two main categories, depending on whether or not there is an obstruction to blood flow.

What symptoms might someone with HCM experience?

This is the most important thing. Some people can go for years without any symptoms. But others may develop some symptoms. It is very important for you to have an idea about these too.

• Chest pain: A tightness or pain in the chest, especially during exercise or exertion.
• Dizziness and fainting: Feeling dizzy when standing up suddenly or when exercising, sometimes leading to loss of consciousness.
• Shortness of breath: Difficulty breathing, even after doing a little work or walking a short distance.
• Palpitations: A feeling of the heart beating rapidly and the chest heaving.
• Swelling (Edema): Swelling of the veins in the legs, ankles, or neck.

Why does this situation occur?

A question many people ask is, "Why did this happen to me?" There are two main causes of HCM.

1. Genetic Cause: About 3 out of 5 people with HCM have this condition because of changes in their genes. Simply put, it is hereditary . It is caused by a defect in the genes that control the growth of the heart muscle. It is inherited in an autosomal dominant manner. This means that if either parent has the defective gene, there is a 50% chance that their child will inherit it. However, the severity of the disease can vary even within the same family. Some people may have the gene but not develop the disease.

2. No cause found: In 2 out of 5 HCM patients, no specific cause can be found. This means there is no genetic influence. Researchers are still studying this.

Although this condition can occur at any age, it is most often diagnosed around the age of 40.

What complications can occur due to HCM?

This may sound scary, but it's important to be aware. If left untreated, HCM can lead to complications. But remember, the majority of people with HCM do not develop serious complications.

Don't be afraid of these things. To protect yourself from these things, we need to have regular medical checkups. Especially if someone in your family has HCM, or if someone has died of a sudden heart attack, it is very important to get checked yourself.

How do doctors diagnose this disease?

When you go to see a doctor, he will follow several steps to find out if you have this disease.

• Medical history: First, you will be asked about your symptoms, whether anyone in your family has heart disease, or whether anyone has died suddenly.
• Physical exam: The doctor will listen to your heart and lungs using a stethoscope. If you have obstructive HCM, you may sometimes hear a heart murmur.
• Special tests:
• ECG (Electrocardiogram): This is the first test done. This test records the electrical activity of the heart and can detect abnormalities in many people with HCM.
• Echocardiogram (Echo): This is the most important and definitive test for diagnosing HCM. It is like a scan of a baby. It can clearly see the thickness of the heart muscle, how the heart is working, and how it is pumping blood.

In addition to these main tests, the doctor may recommend further tests if necessary.

• Blood tests
• Cardiac catheterization
• Cardiac MRI scan
• A ``Holter monitor'' test that monitors the heart rate for 24 hours or more
• Exercise stress echo test
• Genetic testing

What are the treatments for HCM?

Once you've been diagnosed with HCM, your cardiologist will determine the best treatment plan for you. The main goal of treatment is to control symptoms and reduce the risk of complications.

1. Lifestyle changes and monitoring

If you have no symptoms and are at low risk of complications, your doctor may monitor your condition by examining you regularly and advising you to adopt a heart-healthy lifestyle.

• Completely abstain from smoking.
• Eating heart-healthy foods (low in salt and oil).
• Getting enough sleep.
• Engaging in gentle and moderate exercise as directed by a doctor (vigorous exercise may not be appropriate).
• Maintaining a healthy weight.
• Good control of other medical conditions such as high blood pressure and diabetes.

2. Medications

Various medications are used to control symptoms.

• Beta-blockers: They slow down the heart rate and reduce the pressure on the heart.
• Calcium channel blockers: Relax the heart muscle and facilitate blood flow.
• Diuretics: They remove excess fluid from the body and reduce symptoms such as shortness of breath.

Recently, a new drug called `(mavacamten)` has been introduced. This is the first drug that targets the underlying cause of HCM.

3. Special Procedures and Surgeries

There are special treatments for conditions that cannot be controlled with medication, especially obstructive HCM, and to prevent complications.

What to expect when living with HCM?

There is no need to be afraid of being told you have HCM. Most people can live a normal life with proper treatment and management. While the mortality rate from this disease was high in the past, today, thanks to advanced treatments, that risk has come down to a very low level of 0.5%.

The most important thing for you is to maintain regular contact with your cardiologist. Get regular checkups, take your medications, and maintain your lifestyle as he or she recommends.

Can this disease be prevented?

Since HCM is often caused by genetic factors, there is no way to prevent it from occurring. But the best thing we can do is to prevent complications . The best way to do that is to undergo screening tests to detect the disease early.

If someone in your family (mother, father, siblings, children) has HCM, you should definitely get tested.

First, you will have an ECG and an Echocardiogram. Even if those tests are normal, it is advisable to have them checked every 3 years until you are 30 and then every 5 years.

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