Hypertrophic cardiomyopathy (HCM)

Hypertrophic cardiomyopathy (HCM) is a disease in which the heart muscle (myocardium) becomes abnormally thick (hypertrophied). The thickened heart muscle can make it harder for the heart to pump blood. Hypertrophic cardiomyopathy is very common and can affect people of any age. About one out of every 500 people has HCM. It affects men and women equally.

Other Names for Hypertrophic Cardiomyopathy

  • Asymmetric Septal Hypertrophy
  • Familial Hypertrophic Cardiomyopathy
  • Hypertrophic Obstructive Cardiomyopathy
  • Hypertrophic Non-obstructive Cardiomyopathy
  • Idiopathic Hypertrophic Sub-aortic Stenosis (IHSS)

Causes of Hypertrophic Cardiomyopathy:

HCM is a genetic condition caused by a change or mutation in one or more genes and is passed on through families. Each child of someone with HCM has a 50 per cent chance of inheriting the condition. HCM is a common cause of sudden cardiac arrest (SCA) in young people, including young athletes.

HCM also can affect the heart’s mitral valve, causing blood to leak backward through the valve. Sometimes, the thickened heart muscle doesn’t block blood flow out of the left ventricle. This is called non-obstructive hypertrophic cardiomyopathy. The entire ventricle may thicken, or the thickening may happen only at the bottom of the heart. The right ventricle also may be affected.

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Symptoms of HCM:

Many people with HCM don’t experience any symptoms. However, the following symptoms may occur during physical activity:

You may find that you never have any serious problems related to your condition, and with treatment, your symptoms should be controlled. However some people may find that their symptoms worsen or become harder to control in later life.

The area of heart muscle that is affected by HCM and the amount of stiffening that occurs will determine how the symptoms affect you.

For some people, a number of other conditions can develop as a result of having HCM. These may include abnormal heart rhythms, or arrhythmias, including heart block and endocarditis.

Other symptoms that might occur, at any time, include:

  • Chest pain
  • Palpitations
  • Shortness of breath
  • High blood pressure
  • Light headedness and fainting

 

Diagnosis of Hypertrophic Cardiomyopathy:

The health care provider will perform a physical exam and listen to the heart and lungs with a stethoscope. Signs may include abnormal heart sounds or a heart murmur. These sounds may change with different body positions, High blood pressure, the pulse in your arms and neck will also be checked. The doctor may feel an abnormal heartbeat in the chest.

Close family members of people who have been diagnosed with hypertrophic cardiomyopathy may be screened for the condition. Tests used to diagnose heart muscle thickness, problems with blood flow, or leaky heart valves (mitral valve regurgitation) may include:

  • Echocardiography, ECG
  • Cardiac catheterization
  • MRI of the heart, Chest X-ray
  • Transesophageal echocardiogram (TEE)
  • 24-hour Holter monitor (heart rhythm monitor)

Risk Factors include:

Any strenuous exercise that increases after load (i.e., heavy weight lifting/training) can theoretically increase the magnitude of LV hypertrophy over time and thus worsen obstruction in subjects with pre-existing HCM. Risk factors for the development of end-stage HCM (manifesting as LV systolic dysfunction and LV dilation) include younger age of onset/presentation of HCM, a family history of HCM, increased ventricular wall thickness, along with the presence of certain genetic mutations in certain individuals.

Treatment of HCM:

At present there is no cure for HCM, but treatments are available to help control your symptoms and prevent complications. Your treatment will depend on how your heart is affected and what symptoms you have. You may need:

  • A Pacemaker – to control your heart rate
  • Medicines – to help control your blood pressure, abnormal heart rhythms
  • An ICD – if you are at risk of having a life threatening abnormal heart rhythm

Seek counsel from our Houston Cardiologist if you suspect you are suffering from Hypertrophic Cardiomyopathy (HCM) for the best treatment options for you.

Visit us at: www.advancedcardiodr.com|Call: +1 281-866-7701.

Automatic Implantable Cardioverter-Defibrillator (AICD)

Automatic Implantable Cardioverter-Defibrillator (AICD) is a device that monitors a person’s heart rate. They are generally implanted into heart failure patients. AICD intended to convert life threatening rhythms of the heart which may cause sudden cardiac death also known as cardiac arrest, to a sinus (normal) rhythm. An abnormal heart beats are referred to as arrhythmias either one that beats too fast (Tachycardia), too slow (Brachycardia) or irregularly referred as Atrial Fibrillation.

Defibrillators treat arrhythmias in two ways: in the first instance the device tries to stop the abnormal rhythm with a burst of high speed pacing. If that fails, the device will deliver an electrical shock to the heart to reset its rhythm. Patients are usually not aware of cardioversion and nearly always aware of defibrillation. It is also capable of collecting and storing information about your heart’s electrical activity for your cardiologist to check. Cardiologist will program the defibrillator to deliver the best therapy for you.

The AICD gives your heart a shock if you suspect life threatening arrhythmias or an abnormally high heart rate. Some arrhythmias can cause the heart to completely stop beating. The shock given by the AICD can make the heart start beating normally again. An AICD can also make your heart beat faster if your heart is not beating fast enough.

The AICD System Consists of:

A small computer chip that tells the AICD when to deliver a shock

Batteries designed to last 4 to 5 years and deliver about 100 shocks

A pulse generator that can send an electrical impulse or shock to the heart

Electrodes that sense the rhythm of the heart and deliver a shock to the heart muscle

Doctor can also program the AICD to deliver a variety of sophisticated electrical therapies depending on the type of abnormal rhythm problem being treated.

Procedure:

An intravenous (IV) line will be started in your arm. Your doctor will inject a local anesthetic to numb the site where the device will be placed. Typically AICDs are implanted just under the collarbone, usually on the left side. Your doctor will make a small incision in the skin. From there, lead wires are passed through a vein to your heart and then tested to check their position in your heart. A little pocket is made under the skin for the pulse generator. It is about the size of a book of matches. The leads are connected to the pulse generator, and tested. Then your doctor will close the incision and program the device.

Potential Risks or Complications Associated with the Implantation:

The procedure is extremely safe, with a low risk of complication. Most complications are minor and easily treated, such as pain, bleeding and bruising at the implant site.

An infrequent complication is pneumothorax, a condition when the lung is accidentally punctured during the insertion of the lead. Air then leaks into the chest cavity, causing the lung to collapse. This condition can be treated with insertion of a chest tube to allow the air to escape and the lung to re-expand.

A rare but serious complication is infection of the implant site or the pulse generator/lead, requiring antibiotic therapy and even surgical removal of the entire AICD system if severe.

Factors that may Increase the Risk of Complications Include:

Obesity

History of smoking

Use of certain medications

Chronic diseases such as diabetes

Bleeding or blood-clotting problems

History of excess alcohol consumption

Symptoms:

Have chest pain or shortness of breath

Feel lightheaded and do not feel a shock

Call for medical help right away if you experience above life threatening symptoms. Seek counsel from our Heart Doctors in Houston for the best treatment options for you.

Visit us at: www.advancedcardiodr.com|Call: +1 281-866-7701

 

Diagnostic Tests

In order to properly diagnosis an illness, an individual must undergo a series of tests. Some medical tests are simply a physical examination. Other tests require elaborate equipment used by medical technologists or the use of a sterile operating environment.
Specifically, a diagnostic test is a kind of medical test performed to aid in the diagnosis or detection of a disease.

For example, diagnostic tests can:

•    Diagnose diseases
•    measure the progress or recovery from disease
•    confirm that a person is free from disease

In the case of cardiologists, diagnostic tests are critical in detecting and monitoring illnesses of the heart and surrounding tissues.

For example, following are a few of the more common cardiology diagnostic tests:

•    Blood test
•    CAT Scans
•    Echocardiography
•    Electrocardiograms (EKG)
•    Exercise Stress Tests
•    MRIs
•    Cardiac catherization
•    Cardiac biopsy

Diagnostic tests are a safe way to look inside the heart and determine not only the ailment, but possibly the safest and most effective treatment option. Cardiologists rely on diagnostic testing to monitor a disease and watch its progression or improvement.

If preventative measures weren’t enough to keep you from falling victim to a heart or blood vessel disorder, in best case scenarios, diagnostic testing can quite possibly catch the ailment in an early stage where treatment is non-invasive and rapid.

If you fear you may suffer from a heart disorder, see your cardiologist immediately to gain an accurate diagnosis and an effective treatment plan.

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