Hypertrophic Cardiomyopathy

Treatment for hypertrophic cardiomyopathy depends on the severity of the condition. Hypertrophic cardiomyopathy is a genetic condition, and there is currently no cure. However, in April 2022, the FDA approved the medication, Mayacamtem, to treat people with symptoms of obstructive hypertrophic cardiomyopathy.

The treatments for people who experience symptoms of hypertrophic cardiomyopathy focus mainly on managing the condition with medication and additional medical procedures. The severity of the condition will determine how the symptoms are managed to prevent the worsening of hypertrophic cardiomyopathy.

NewYork-Presbyterian is one of the few hospitals in the United States with a designated care center for patients with hypertrophic cardiomyopathy. We retain the highest level of skilled surgeons who are experts in the fields of cardiology and cardiac surgery. With state-of-the-art technology, using the latest equipment available, we provide high-quality and advanced heart care. The full range of therapies available at NewYork-Presbyterian includes medication, surgery, pacemakers, and other implantable devices. 

Healthy lifestyle

People who do not exhibit symptoms should maintain a healthy lifestyle to decrease their chances of developing complications. This is especially recommended if a person has additional medical conditions such as diabetes or high blood pressure. Adopting a heart-healthy regimen should include:

• Eating healthy
• Exercising
• Maintaining a healthy weight
• Getting enough sleep
• Don’t smoke

Medications

Medications to treat hypertrophic cardiomyopathy should be taken as prescribed. These medications are designed to improve symptoms and heart function by increasing blood flow and the heart’s ability to pump blood. Medications are used to lower blood pressure, slow the heart rate, remove excess fluid retained in the body, and prevent blood clots. Medications include:

• Beta blockers
• Calcium channel blockers
• Diuretics
• Myosin inhibitors

Nonsurgical options

Hypertrophic cardiomyopathy can be treated with non-surgical procedures. These include:

• Alcohol septal ablation – This procedure involves ethanol alcohol being injected through a small tube into the artery that supplies blood to the thickened heart muscle damaged by hypertrophic cardiomyopathy. The alcohol destroys these cells, allowing the heart muscle to shrink to normal size, thus allowing blood to flow through the area. Heart surgery complications and risks increase with age; therefore, alcohol septal ablation is the preferred procedure for older patients.

Surgical options

• Septal myectomy – This open-heart surgery is an option for people whose severe obstructive hypertrophic cardiomyopathy cannot be controlled with medication. A heart surgeon will remove the thickened portion of the septum that extends into the left ventricle. The elimination of this damaged portion allows blood to flow freely to the heart and the rest of the body. 
• Cardiac implantable electronic devices (CIEDs) – These devices are surgically implanted in the body to improve heart function:
  • Implantable cardioverter defibrillator (ICD) – This device sends an electric shock to the heart when an irregular heartbeat is detected, reducing the risk of death from sudden cardiac death.
  • Pacemaker – This device is implanted under the skin of the chest or abdomen. It is often used to correct a slow heartbeat. Electrical pulses are used to regulate the heartbeat.
  • Ventricular assist device (VAD) – This procedure is considered when less invasive procedures were not successful. The device helps blood through the heart and is used either short or long term for people waiting for a heart transplant.
• Heart transplant – This procedure is used for people with end-stage hypertrophic cardiomyopathy; the damaged heart is replaced with a new, healthy donor heart.