Hypertrophic Cardiomyopathy

Disease Description

Hypertrophic cardiomyopathy (HCM) is a genetically determined heart disease characterized by thickening of the left ventricular walls, most commonly due to hypertrophy of the interventricular septum. This may lead to left ventricular outflow tract obstruction, creating a mechanical barrier to normal blood flow from the heart.

Causes of the Disease

The disease is caused by genetic mutations that result in abnormal organization of heart muscle cells (cardiomyocytes) and disarray of myocardial fibers.

Symptoms

Typical symptoms of hypertrophic cardiomyopathy include shortness of breath during physical exertion, chest pain of varying intensity, palpitations, dizziness, and pre-syncope or syncope (near-fainting or fainting episodes).

The appearance of these symptoms is a clear reason to consult a cardiologist and undergo a comprehensive cardiac evaluation.

This can be done at our Cardiac Surgery Center.

Diagnosis

Diagnosis of hypertrophic cardiomyopathy обязательно includes electrocardiography (ECG) and echocardiography (EchoCG).

Echocardiography allows detection of myocardial thickening and left ventricular outflow tract obstruction, as well as assessment of heart valve function — most commonly involving the mitral valve.

When surgical treatment is being considered, advanced imaging methods play a crucial role. Cardiac multislice computed tomography (MSCT) allows precise evaluation of the severity and localization of myocardial hypertrophy.

Treatment

In patients with obstructive hypertrophic cardiomyopathy who have significant symptoms and do not respond adequately to medical therapy, surgical intervention is indicated.

One treatment option is alcohol septal ablation, which involves injecting ethanol into the artery supplying the hypertrophied portion of the myocardium. This causes controlled necrosis and subsequent thinning of the septum, reducing obstruction.

However, the gold standard for treating hypertrophic cardiomyopathy with left ventricular outflow tract obstruction is the Morrow procedure (septal myectomy). This operation is performed using cardiopulmonary bypass and involves surgical resection of the thickened interventricular septum that obstructs blood flow.

Treatment Prognosis

Without treatment, the prognosis of hypertrophic cardiomyopathy is unfavorable, as progressive heart failure symptoms may lead to severe complications, including sudden cardiac death.

Timely diagnosis, appropriate medical therapy, and modern surgical treatment options can stabilize the condition, reduce the risk of disease progression, and significantly lower the risk of complications.