What Is the Life Expectancy of Someone with Hypertrophic Cardiomyopathy?

Symptoms of hypertrophic cardiomyopathy include sudden cardiac death.

Hypertrophic cardiomyopathy is a chronic, genetic heart disease that causes the heart muscle to become thickened and enlarged, or hypertrophied. Hypertrophic cardiomyopathy also causes abnormal heart cells that are disorganized and, in some cases, scarred. In some patients, the mitral valve may be affected.

Frequently, patients with hypertrophic cardiomyopathy have few to no symptoms, or only symptoms with exercise or exertion. Symptoms of hypertrophic cardiomyopathy may start during puberty when hypertrophy develops, but they most commonly occur in mid-life and worsen over time.

Symptoms of hypertrophic cardiomyopathy include:

• Sudden cardiac death 
• Shortness of breath (most common symptom)
• Lightheadedness
• Fainting or syncope
• Chest pain (angina)
• Heart palpitations
• Abnormal heart rhythms
• Dizziness
• Lack of energy
• Swelling of the legs and feet
• Exercise intolerance
• Difficulty breathing when lying down and shortness of breath during sleep (both are early signs of congestive heart failure)
• Congestive heart failure (uncommon)

About half of all cases of hypertrophic cardiomyopathy are the result of genetic mutations that are passed on in families. The other half are acquired mutations. 

Causes of acquired hypertrophic cardiomyopathy include: 

• Aging
• Smoking
• Obesity
• Chronic high blood pressure (hypertension)
• Exposure to asbestos
• Inflammatory cells (sarcoidodis)

Patients suspected of hypertrophic cardiomyopathy may be referred for cardiology testing. Physical exam findings may reveal an abnormal sound in the heart called a murmur. Tests such as EKGs may be abnormal in otherwise asymptomatic patients.

Currently, genetic testing is becoming more available to test for hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy is often diagnosed with imaging tests such as:

• Two-dimensional (2-D) echocardiography 
• Chest X-rays
• Radionuclide imaging
• Cardiac magnetic resonance imaging (MRI)

Other diagnostic methods may be used including:

• Cardiac catheterization 
• Electrophysiologic studies

Hypertrophic cardiomyopathy may be treated with medications including:

• Beta-blockers
• Calcium channel blockers
• Diltiazem, amiodarone, and disopyramide (rarely)
• Antitussives to prevent coughing

Surgical and catheter-based therapies include:

• Left ventricular myomectomy
• Mitral valve replacement
• Permanent pacemaker implantation
• Catheter septal ablation
• Placement of an implantable cardioverter defibrillator
• Heart transplantation

Complications of hypertrophic cardiomyopathy include:

• Sudden cardiac death
• Atrial fibrillation (A-Fib), which can increase the risk of blood clots and stroke
• Blood flow obstructions which can result in chest pain, dizziness, shortness of breath, and lightheadedness/fainting
• Problems with the mitral valve
• Congestive heart failure
• Dilated cardiomyopathy
• Sudden fainting (syncope) with bodily injury
• Severe exercise intolerance

The majority of patients with hypertrophic cardiomyopathy have no symptoms and most have a near-normal life expectancy. 

In some cases, sudden cardiac death is the first symptom of the illness.

Patients who have symptoms at a younger age often have higher mortality rates.

Hypertrophic cardiomyopathy is a progressive and chronic condition that worsens over time if not treated promptly and appropriately.