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Hypertrophic obstructive cardiomyopathy is the most common cause of sudden death in people under the age of 30. The disease can be congenital in young people or acquired in the elderly. The disease involves the abnormal thickening of heart muscle, which often leads to obstruction of the flow of blood out of the heart and to symptoms of heart failure, myocardial ischemia and sudden passing out.
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Patients with hypertrophic obstructive cardiomyopathy have abnormally thickened walls of the left ventricle, the heart's main pumping chamber. The interventricular septum - the wall of muscle between the two ventricles of the heart - is often excessively thickened. This thickened wall can interfere with the function of the mitral valve and can block the flow of blood out of the heart. The inefficient blood flow causes the pressure in the heart to increase, making the left ventricle work harder, resulting in further thickening of the walls of the left ventricle over time. Symptoms associated with HOCM can include chest pain, shortness of breath, palpitations, syncope (sudden fainting), and even sudden death.
Treatments for HOCM include medication to control the heart's contraction, insertion of pacemakers to prevent arrhythmias, and when medications fail - surgical resection of the thickened septum, making it thinner. alcohol septal ablation as an alternative to surgery in select patients. This relatively new treatment for HOCM actually reduces the obstruction and improves blood flow out of the heart. In addition, it often improves the function of the mitral valve.
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