Often people with hypertrophic cardiomyopathy (HCM) remain undiagnosed because they have few or no symptoms. The symptoms that might be present - such as shortness of breath, chest pain, and fainting - tend to occur during heavy physical work or exercise. Other symptoms include feeling dizzy or exhausted. You may also experience heart palpitations in which your heart beats unusually hard or fast. With HCM there is also danger of abnormal heart rhythms, or arrhythmias, which can lead to sudden cardiac death.
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Piedmont Heart Institute answered
In hypertrophic cardiomyopathy (HCM), the muscle of the lower left chamber of the heart (the left ventricle) becomes abnormally thick and enlarged. If blood flow out of the heart is obstructed due to the thickened heart muscle, a number of symptoms may result, including:
- Shortness of breath during physical activity (which may signal heart failure)
- Fainting (also called syncope) with activities
- Chest pain caused by a reduced supply of blood to the heart (called angina),
- Abnormal heart rhythms, which in some cases can lead to sudden death unless the heart is electrically “shocked” to restart a normal rhythm
- Heart murmur, a whooshing sound that your doctor may hear through a stethoscope
Sometimes a patient will have no symptoms but may suddenly experience cardiac arrest. For this reason, even those who have HCM but no symptoms need to be followed up regularly to assess their risk for sudden death and to consider preventive treatments, such as implantation of a cardiac defibrillator to shock the heart back to a normal heartbeat if a dangerous heart rhythm develops.
Many patients with hypertrophic cardiomyopathy (an abnormal increased thickness of the heart muscle) have minimal or no symptoms. For some patients, the symptoms develop so gradually that they become accustomed to the symptoms and don’t realize there is a problem. The symptoms can worsen over time until they eventually limit a patient’s activity level.
One or more of the following symptoms can occur in patients with hypertrophic cardiomyopathy:
• Shortness of breath usually occurs with activity. It can limit a patient’s ability to tolerate exercise. For some patients, the shortness of breath becomes worse after meals. For these patients, it is recommended they eat smaller but more frequent meals.
• Chest pain or pressure is referred to in the medical field as angina. It most often occurs with or right after activity and improves with rest. The pain develops because the thickened heart muscle is demanding more oxygen than it is receiving. For some patients, this also occurs after eating a meal. Again, smaller and more frequent meals can help prevent the episodes of pain.
• Lightheadedness or fainting spells (also called syncope) may occur when bending over or with activity. These symptoms occur because the brain is not getting enough blood flow due to an obstruction in the heart or an abnormal heart rhythm. If you experience a fainting or near-fainting spell, you should report it to your doctor immediately.
• Palpitations are uncomfortable sensations in the chest that feel like the heart is pounding or racing. These sensations can be a result of an abnormal heart rhythm and may be associated with sweating, shortness of breath or chest pain. The episodes may last only seconds or continue on for long periods of time.