What Medications Are Used to Treat Hypertrophic Cardiomyopathy?
Often, drugs are used to treat symptoms and prevent further complications of HCM. Medications can help relax the heart and reduce the degree of obstruction so the heart can pump more efficiently. Beta-blockers and calcium channel blocker blockers are two classes of medications that may be prescribed. If you have an arrhythmia, your doctor may prescribe medications to control your heart rate or decrease the occurrence of arrhythmias.
You may be told to avoid certain medications, such as nitrates, because they lower blood pressure, or digoxin, because it increases the force of the heart’s contraction.
Non-obstructive HCM symptoms may be treated with medications. If heart failure occurs, treatment is aimed at controlling it through heart failure medications and diet changes.
Your doctor will discuss which medications are best for you.
What Surgical Procedures Are Used to Treat Hypertrophic Cardiomyopathy?
Surgical procedures used to treat HCM include:
Septal myectomy. During this surgical procedure, the surgeon removes a small amount of the thickened septal wall of the heart to widen the outflow tract (the path the blood takes) from the left ventricle to the aorta.
Ethanol ablation. First, a cardiologist (heart doctor) performs a cardiac catheterization to locate the small coronary artery that supplies blood flow to the septum. A balloon catheter is inserted into the artery and inflated. A contrast agent is injected to locate the swollen septal wall that narrows the passageway from the left ventricle to the aorta. When the bulge is located, a tiny amount of pure alcohol is injected through the catheter. The alcohol kills the cells on contact, causing a small “controlled” heart attack. The septum then shrinks back to a more normal size over the following months, widening the passage for blood flow.
Implantable Cardioverter Defibrillators (ICD). ICDs are suggested for people at risk for life-threatening arrhythmias or sudden cardiac death. The ICD constantly monitors the heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle to cause the heart to beat in a normal rhythm again.
Hypertrophic Cardiomyopathy, Sudden Death, and Endocarditis
A small number of people with HCM have an increased risk of sudden cardiac death. People at risk include:
- Those who have family members who have had sudden cardiac death.
- Young people with HCM with several episodes of fainting.
- Those who have an abnormal blood pressure response with exercise.
- Adults who have a history of arrhythmia with a fast heart rate.
- Those with severe symptoms and poor heart function.
If you have two or more risk factors for sudden cardiac death, your doctor will treat you with medications to prevent arrhythmias or with an ICD. Most people with HCM are at low risk for sudden cardiac death. Talk to your doctor about any concerns you may have.
How Can I Prevent Endocarditis?
People with obstructive HCM may be at increased risk for infective endocarditis, a potentially life-threatening condition. Ask your doctor if you need to take endocarditis precautions, which include:
- Tell all your doctors and dentist you have HCM. They should prescribe antibiotics to prevent an infection before performing any procedures on you that may cause bleeding (dental, respiratory, and gastrointestinal procedures).
- Call your doctor if you have symptoms of an infection.
- Take good care of your teeth and gums.
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