Treatment of Hypertrophic Cardiomyopathy

Written by Tang Li
Cardiology
Updated on September 13, 2024
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Hypertrophic cardiomyopathy, due to unknown causes and often related to genetic factors, is difficult to prevent. It is important to guide patients on how to lead their lives, reminding them to avoid intense physical activities, heavy lifting, or breath-holding to reduce the incidence of sudden death. Avoid using drugs that enhance myocardial contractility and reduce cardiac capacity load, such as digoxin and nitrates, to decrease the aggravation of left ventricular outflow tract obstruction. The treatment principle for this disease is to slow down the hypertrophy of the myocardium, prevent tachycardia, and maintain normal sinus rhythm. It also aims to relieve the narrowing of the left ventricular outflow tract and counteract arrhythmias. Currently, the use of beta blockers and calcium channel blockers is advocated. For severe obstructive patients, interventional and surgical treatments can be carried out, including the implantation of a dual-chamber DTD pacemaker, and the ablation or removal of hypertrophied interventricular septum myocardium.

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Can people with cardiomyopathy run?

Whether a person with myocardial disease can run or not depends on the extent of myocardial damage and clinical symptoms. If the myocardial damage is severe and there are significant clinical symptoms of heart failure and arrhythmia, this group should not run and needs bed rest. If strenuous activity would worsen heart failure, the myocardial damage is mild, with no typical clinical symptoms, and does not affect daily activities, this group can engage in appropriate exercises like walking or running, but the duration should not be too long, about 20 to 30 minutes each time.

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Is cardiomyopathy life-threatening?

Whether cardiomyopathy poses a threat to life depends on the severity of the condition. Mild myocardial damage, if detected early, diagnosed early, and treated with effective medications in a timely manner, generally has a good prognosis, poses no threat to life, and leaves no sequelae. Severe myocardial damage, due to lack of timely treatment, can lead to serious complications such as heart failure, arrhythmias, and cardiogenic shock, which can endanger life safety. Therefore, early diagnosis, early treatment, and prevention of complications are crucial treatment measures for cardiomyopathy.

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Written by Xie Zhi Hong
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How to recover from decreased physical fitness due to dilated cardiomyopathy?

Dilated cardiomyopathy is diagnosed after excluding conditions such as hyperthyroidism, hypertension, coronary heart disease, cardiac hypertrophy, or myocarditis as underlying causes. Generally, the exact cause of dilated cardiomyopathy is unknown, rendering causal treatment impossible. Once diagnosed with dilated cardiomyopathy, it is impossible to completely cure the condition. The only approach is to manage symptoms and prevent further progression of the disease. Typically, this involves the use of beta-blockers, ACE inhibitors, and diuretics. If the patient has severe cardiac dysfunction, drugs like digoxin, which strengthen heart function, may be considered. If medication does not adequately control the condition, other treatments like CRT might be considered, as well as the use of phosphodiesterase inhibitors, diuretics, or intravenous cardiotonic glycosides.

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Cardiology
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What is the prognosis of hypertrophic cardiomyopathy?

The prognosis of hypertrophic cardiomyopathy varies greatly, and it is the primary cause of sudden death in adolescents and athletes because it can progress to end-stage heart failure. Additionally, a small percentage may experience heart failure, atrial fibrillation, and embolism, but many patients have mild symptoms and can have a life expectancy close to normal. For the treatment of hypertrophic cardiomyopathy, adequate sudden death risk assessment and ICD prevention should be conducted. Because hypertrophic cardiomyopathy is the most common cause of sudden cardiac death in young people and athletes, an ICD can effectively prevent the occurrence of sudden death. Preventing high-risk factors, including previous cardiac arrest, one or more sudden deaths in first-degree relatives, severe left ventricular hypertrophy, and findings of repetitive non-sustained ventricular tachycardia on a 24-hour Holter monitor, low blood pressure during exercise, and unexplained syncope, especially during exercise, poses a high risk of sudden death in these patients.

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Written by Zhang Yue Mei
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What causes cardiomyopathy?

In clinical practice, the most common type of myocarditis is viral myocarditis. Due to a decrease in the body's resistance, the virus invades and damages the myocardium, causing localized and diffuse inflammatory damage to the heart muscle, which poses significant harm to the body. The early clinical symptoms of viral myocarditis often manifest primarily as respiratory and gastrointestinal symptoms, accompanied by palpitations and shortness of breath, necessitating the use of electrocardiograms and myocardial enzyme spectrum tests. Early detection, diagnosis, and treatment of viral myocarditis play a crucial role in the prognosis.