Apical hypertrophic cardiomyopathy is a rare heart condition characterized by the thickening of your heart muscle near the bottom of your left ventricle.
Apical hypertrophic cardiomyopathy (HCM) can cause symptoms like reduced exercise ability and shortness of breath.
The name can be broken into several parts:
- Myopathy: This is a condition that affects your muscle tissue.
- Cardiomyopathy: This is a condition that affects your heart muscle.
- HCM: This is thickening of your heart muscle, which makes it harder for your heart to pump blood.
- Apical HCM: This is a rare form of HCM that usually involves the bottom of your left ventricle. This area is also called the apex.
Read on to learn more about this rare condition, including its symptoms, causes, and treatment options.
Apical HCM doesn’t always cause symptoms. When symptoms do appear, they’re often general and can mimic those of other conditions. They may include:
Apical hypertrophic cardiomyopathy and exercise
HCM causes thickening of your heart’s left ventricle walls at its apex. This thickening can cause your left ventricle to not be able to pump as much blood.
Less blood pumping may lead to shortness of breath, especially during exercise since your tissues require more blood and oxygen during exercise than at rest.
Some doctors recommend for people with HCM to avoid vigorous exercise due to concern over sudden cardiac death. But, in a 2023
HCM is linked to dominant genes passed through a person’s family for most people who have it. More than
HCM seems to be particularly common in Japan and other Asian countries compared with the United States. About
Apical HCM can lead to
- atrial fibrillation
- problems with the functioning of your ventricles
- chest pain
- pulmonary hypertension
- ventricular arrhythmia
For some people, their first symptom is a severe cardiovascular event,
- sudden cardiac death
- stroke
- heart attack
- congestive heart failure
The diagnostic process for HCM often starts with visiting a primary care doctor, who will:
- review your personal and family medical history
- perform a physical exam
- consider your symptoms
If they suspect you have a heart condition, they may refer you to a heart specialist called a cardiologist.
The main test cardiologists use to diagnose HCM is an echocardiogram. This is a type of ultrasound that produces an image of your heart and can show the doctor thickened areas of your heart muscle.
For some people, a doctor will use a transesophageal echogram, where a probe is inserted down your throat while you’re sedated.
Other
- electrocardiography (ECG or EKG)
- heart magnetic resonance imaging (MRI)
- heart stress tests
- 24-hour Holter monitoring
- genetic blood tests
- cardiac catheterization to confirm the diagnosis and prepare for surgery
Current treatment
If you don’t have any symptoms, a doctor may recommend regular monitoring alone. If you do have symptoms, they may recommend medications like beta-blockers or calcium channel blockers.
Rarely, if medications aren’t effective, you may require
- Septal myectomy: This procedure involves removing a portion of the thickened septum (the wall between the heart’s chambers) to relieve obstruction in the left ventricle and improve blood flow.
- Alcohol septal ablation: This procedure involves injecting alcohol into the coronary artery that supplies the thickened septum, causing controlled damage to reduce septal thickness and improve blood flow.
- Mitral valve repair or replacement: Some people with HCM may develop mitral valve issues that may require surgical repair or replacement of the mitral valve to improve heart function.
- Internal cardiac defibrillator (ICD) placement: In cases where your care team suspect you are at a high risk of life-threatening arrhythmias (irregular heart rhythm) that can lead to sudden cardiac arrest, they
may recommend an ICD. This is a small electronic device implanted in your chest or abdomen to continuously monitor and regulate your heart’s rhythm.
People with end stage heart disease that’s unresponsive to other treatments may require a heart transplant.
HCM is often linked to gene mutations passed through families and may not always be preventable. You may be able to support your overall heart health by:
- quitting or avoiding smoking (quitting is often difficult, but a doctor can build a cessation plan that works for you)
- staying physically active
- eating a healthy overall diet
- maintaining a healthy weight
- getting enough sleep
- treating other medical conditions like:
The symptoms of apical HCM are generally vague and can mimic those of many other conditions. It’s important to see a doctor if you notice any concerning symptoms like:
- trouble breathing
- shortness of breath
- decreased exercise ability
Once you’ve received a diagnosis, it’s important to attend all your regular follow-ups and contact a doctor if you notice a change in your symptoms.
The outlook for most people with apical HCM is usually good, and it generally doesn’t affect your quality of life or life span. Your risk of sudden cardiac death seems to be lower if you have apical HCM than if you have another form of HCM.
Some of the risk factors for sudden cardiac death include:
- history of cardiac arrest
- family history of sudden cardiac death
- unexplained dizziness
- left ventricular thickness of more than 30 millimeters
Here are some frequently asked questions people have about HCM.
Apical HCM can cause limited exercise ability and trouble breathing. It’s associated with lower rates of sudden cardiac death than other forms of the disease.
HCM may be at least partially reversible with exercise.
People with HCM usually have a typical life span. Most people aren’t at risk of developing serious complications.
Apical HCM often doesn’t cause symptoms. When symptoms do appear, they often mimic those of many other conditions.
A doctor can help you figure out if any particular treatment is needed for your condition. Many people with apical HCM have a typical life span and quality of life, although regular monitoring is often recommended.