Hypertrophic Cardiomyopathy: Treatment, Procedure, Cost and Side Effects

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The goal of hypertrophic cardiomyopathy treatment is to relieve symptoms and prevent sudden cardiac death in people at high risk. Specific treatment varies depending on the severity of your symptoms. Your doctor will discuss with you the most appropriate treatment for your condition. The options include:

Medications. You may be given medications to relax the heart muscle and to slow the heart rate so that the heart can pump more efficiently. Your doctor may recommend beta blockers such as metoprolol (Lopressor, Toprol), propranolol (Inderal, Innopran) or atenolol (Tenormin), calcium channel blockers such as verapamil (Verelan, Calan, Covera) or diltiazem (Cardizem, Tiazac, Dilacor), or medications to control your heart rhythm such as amiodarone (Pacerone) or disopyramide (Norpace). If you have atrial fibrillation, your doctor may prescribe blood thinners such as warfarin (Coumadin, Jantoven), dabigatran (Pradaxa), rivaroxaban (Xarelto) or apixaban (Eliquis) to reduce your risk of blood clots.

Septal myectomy. A septal myectomy is an open-heart procedure in which the surgeon removes part of the thickened, overgrown septum between the ventricles. Removing part of this overgrown muscle improves blood flow and reduces mitral regurgitation. Surgeons may conduct this procedure using different approaches, depending on the location of the thickened heart muscle. In one type of septal myectomy called apical myectomy, surgeons remove thickened heart muscle from near the tip of the heart. Surgeons may sometimes perform mitral valve repair at the same time as a myectomy. A septal myectomy may be recommended if medications don't relieve your symptoms. Most people who have a myectomy have no further symptoms. Septal myectomy is available only in medical centres that specialize in the treatment of hypertrophic cardiomyopathy.

Septal ablation. In septal ablation, a small portion of the thickened heart muscle is destroyed by injecting alcohol through a long, thin tube (catheter) into the artery supplying blood to that area. This procedure may improve your symptoms. Possible complications with this procedure include heart block — a disruption of the heart's electrical system — which requires implantation of a pacemaker.

Implantableer-defibrillator (ICD). Doctors may recommend an ICD if you have life-threatening heart rhythm disorders (arrhythmias) such as ventricular tachycardia or ventricular fibrillation. An ICD is a small device that continuously monitors your heartbeat. It's implanted in your chest like a pacemaker. If a life-threatening arrhythmia occurs, the ICD delivers precisely calibrated electrical shocks to restore a normal heart rhythm. Your doctor may recommend an ICD if you have hypertrophic cardiomyopathy and you're at high risk of sudden cardiac death because of abnormal heart rhythms.

Septal myectomy. A septal myectomy is an open-heart procedure in which the surgeon removes part of the thickened, overgrown septum between the ventricles. Removing part of this overgrown muscle improves blood flow and reduces mitral regurgitation. Surgeons may conduct this procedure using different approaches, depending on the location of the thickened heart muscle. In one type of septal myectomy called apical myectomy, surgeons remove thickened heart muscle from near the tip of the heart. Surgeons may sometimes perform mitral valve repair at the same time as a myectomy. A septal myectomy may be recommended if medications don't relieve your symptoms. Most people who have a myectomy have no further symptoms. Septal myectomy is available only in medical centres that specialize in the treatment of hypertrophic cardiomyopathy.

Septal ablation. In septal ablation, a small portion of the thickened heart muscle is destroyed by injecting alcohol through a long, thin tube (catheter) into the artery supplying blood to that area. This procedure may improve your symptoms. Possible complications with this procedure include heart block — a disruption of the heart's electrical system — which requires implantation of a pacemaker.

Implantableer-defibrillator (ICD). Doctors may recommend an ICD if you have life-threatening heart rhythm disorders (arrhythmias) such as ventricular tachycardia or ventricular fibrillation. An ICD is a small device that continuously monitors your heartbeat. It's implanted in your chest like a pacemaker. If a life-threatening arrhythmia occurs, the ICD delivers precisely calibrated electrical shocks to restore a normal heart rhythm. Your doctor may recommend an ICD if you have hypertrophic cardiomyopathy and you're at high risk of sudden cardiac death because of abnormal heart rhythms.

Women who have hypertrophic cardiomyopathy can generally have normal pregnancies. However, if you have symptoms and complications of hypertrophic cardiomyopathy, your doctor may recommend that you see a doctor experienced in caring for women with high-risk conditions during your pregnancy.

Including two operative deaths (procedural mortality, 0.8%), 1-, 5-, and 10-year overall survival after myectomy was 98%, 96%, and 83%, respectively, and did not differ from that of the general U.S. population matched for age and gender (p = 0.2) nor from patients with nonobstructive HCM (p = 0.8). Compared to nonoperated obstructive HCM patients, myectomy patients experienced superior survival free from all-cause mortality (98%, 96%, and 83% vs. 90%, 79%, and 61%, respectively; p < 0.001), HCM-related mortality (99%, 98%, and 95% vs. 94%, 89%, and 73%, respectively; p < 0.001), and sudden cardiac death (100%, 99%, and 99% vs. 97%, 93%, and 89%, respectively; p = 0.003). Multivariate analysis showed myectomy to have a strong, independent association with survival (hazard ratio 0.43; p < 0.001).

Lifestyle changes can reduce your risk of complications related to hypertrophic cardiomyopathy. Your doctor may recommend lifestyle changes, including: Getting physical activity. Competitive sports are generally not recommended for people with hypertrophic cardiomyopathy. Many people with hypertrophic cardiomyopathy may be able to participate in low- to moderate-intensity exercise as part of a healthy lifestyle. Ask your doctor for guidance.Eating a healthy diet. A healthy diet is an important part of maintaining your heart health.Maintaining a healthy weight. Maintaining a healthy weight will prevent excessive stress on your heart and reduce health risks associated with surgery or other procedures. Reducing alcohol use. If you have symptoms or a history of rhythms provoked by alcohol, ask your doctor for guidance about safe levels of alcohol use. Drinking too much alcohol can trigger irregular heart rhythms and can lead to increased blockage of blood flow in your heart. Taking your medications. Make sure to take your medications as prescribed. Having regular medical appointments. Your doctor may recommend regular follow-up appointments to evaluate your condition. Let your doctor know if you have any new or worse symptoms.

Full recovery from septal myectomy surgery takes about 6 to 8 weeks. Most patients are able to drive in about 3 to 8 weeks after surgery. Your doctor will provide specific guidelines for your recovery and return to work. Your doctor will tell you when you need to have your first follow-up appointment.

The treatment can cost anywhere between 10,000 - 50,000

The results can be permanent as long as the required lifestyle changes are made.