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Updated on July 24, 2025
Hypertrophic cardiomyopathy (HCM) is a disorder that causes the heart muscle to become abnormally thickened. Most cases are genetic and occur due to genes a person inherits from their biological parents. However, there is no identifiable cause in roughly 40 percent of cases. HCM affects people of all ages.
The thickening of the heart muscle most often affects the left ventricle, the chamber of the heart that pumps out oxygenated blood so it can be distributed to the rest of the body. HCM can interfere with the heart’s ability to fill and empty of blood. Chest pain, fast or irregular heartbeat, lightheadedness, dizziness, fainting, and fatigue are common symptoms. Symptoms often get worse with physical activity or exertion.
However, the severity of HCM symptoms can vary considerably from person to person. Some cases cause no symptoms or only mild symptoms, and are detected during routine examinations or family screening when there is a known genetic risk of the disorder. Other cases of asymptomatic HCM are identified after a person dies suddenly from the condition.
HCM that interferes with heart function is referred to as obstructive, while HCM that does not interfere with heart function is referred to as non-obstructive.
Treatment for HCM
There is no cure for HCM, and treatment focuses on reducing symptoms, preventing complications, and slowing the progression of the disease.
Treatment plans for HCM will vary from person to person, and decisions about what treatments to use will be based on a person’s symptoms, overall health, age, and test results used during diagnosis. In addition to a physical exam, diagnosis will include imaging tests that look at the structures of the heart, tests that measure heart function, and the results of blood work.
Obstructive HCM is typically treated with medications. This may include a newer medication called a myosin inhibitor, which has been shown to improve heart function and reduce symptoms. It may also include medications that make it easier for the heart to pump blood or reduce symptoms like chest pain and irregular heartrate.
People with irregular heartrate (arrythmias) may require surgical treatment, such as an implanted pacemaker or defibrillator, surgical treatments to remove or destroy thickened heart muscle, or surgical procedures to relieve obstruction.
Lifestyle interventions when living with HCM
While treatment plans will vary from person to person, everyone with HCM requires routine monitoring and checkups from their healthcare team to look for changes. This includes people with both non-obstructive and obstructive HCM.
Lifestyle changes to help maintain cardiovascular health, slow disease progression, and prevent complications are also recommended to all people living with HCM.
Exercise and physical activity limitations
Exercise and physical activity are important topics to discuss with a healthcare provider, especially for athletes. Some people with HCM may need to avoid strenuous exercise due to the potential risk of severe arrhythmia and cardiac events. However, recommendations and limitations will vary from person to person, and each person should be evaluated individually.
Mild-to-moderate exercise is recommended for most people, but the definition of mild-to-moderate can vary from person to person. Again, the best approach is to talk to a healthcare provider and follow their recommendations.
It’s also worth noting that guidelines can change over time as new research emerges.
Diet and other lifestyle changes
People with HCM are advised to follow a heart healthy diet, avoiding foods high in sugar and unhealthy fats, and building their meals and snacks around vegetables, fruits, whole grains, lean proteins, and healthy fats. People are also advised to maintain a healthy weight. Always consult your healthcare provider before making significant changes to your diet or starting a weight loss program.
Other habits to follow and discuss with a healthcare provider:
- Following good sleep habits
- Managing stress, which can worsen symptoms
- Quitting smoking (if a person smokes) and avoiding environments with secondhand smoke
- Limiting or abstaining from alcohol, as alcohol can worsen heart function
- Managing other health conditions
Remember, everyone has unique healthcare needs, and HCM is a different experience for different people. Your healthcare provider will be your best source of information.
