Hypertrophic Cardiomyopathy (HCM) Symptoms

The hearts of people with hypertrophic cardiomyopathy are thicker, and must beat more forcefully to pump out blood into the body. This can lead to a variety of symptoms, which may appear only occasionally.

• Tightness in the chest or chest pain
• Shortness of breath
• Abnormal heart rhythms or palpitations
• Fatigue
• Dizziness or lightheadedness
• Fainting
• Swelling, especially in the lower body

“Because the symptoms of HCM can occur with many other disease conditions, recognizing HCM can be challenging,” says Jeffrey Geske, MD, a cardiologist at Mayo Clinic in Minnesota. There is no single hallmark symptom that indicates a person has HCM.

It is common for people to notice their symptoms when they exercise, Dr. Geske says. Some people may also experience symptoms when dehydrated or after eating a heavy meal.

There are two main types of HCM: obstructive and nonobstructive. Though both types can impact how well the heart functions, they differ in how much they obstruct blood flow out of the heart. The two types share the same symptoms and require similar treatments.

Obstructive Hypertrophic Cardiomyopathy 

Two-thirds of people with the condition have obstructive HCM. In these cases, the thickened part of the heart blocks and reduces blood flow.

Nonobstructive Hypertrophic Cardiomyopathy

About one third of people with the condition have nonobstructive HCM, in which blood flow out of the heart is not blocked. Nonobstructive HCM may still reduce the amount of blood the heart can pump into the body with each heartbeat, though, because of the thickening and stiffening of the heart muscle.

For many people, HCM is a benign condition and it will not lead to dangerous cardiovascular disease, says Ningxin Wan, MD, a cardiologist at NewYork-Presbyterian Queens and an assistant professor at Weill Cornell Medicine. But that does not mean people who do not have symptoms should ignore follow-up appointments meant to monitor the condition, she says. Regular evaluation and preventive treatment is key to making sure that HCM doesn’t lead to a bad outcome.

“People who have HCM can live a normal lifestyle, unlike other heart diseases that really affect longevity, given that it is recognized and treated early on,” Wan says.

It’s also important to pay attention even to mild symptoms, and how they change over time.

“If I can get one message out to these patients it’s that we have treatments to help with symptoms and if you do not have symptoms, please do not forget that this is a condition that could get worse, and you need to monitor it,” Wan says.

Sudden Cardiac Death

The most severe complication of HCM is sudden cardiac arrest, in which the heart suddenly stops beating. Without emergency treatment, sudden cardiac arrest will result in death.

If you experience any symptoms that could be related to HCM, you should see a doctor, even if those symptoms are mild. Geske highlights the following warning signs as good reasons to get in touch with your healthcare provider:

• Any atypical shortness of breath when exercising
• Chest pain
• Abnormal heartbeat
• Lightheadedness

“Any of these is enough to seek medical attention,” says Geske. A primary care physician or family doctor can begin the process of diagnosing what heart condition you may have.

• The symptoms of hypertrophic cardiomyopathy (HCM) — including chest pain or shortness of breath during exercise, lightheadedness, fatigue, dizziness, and abnormal heart rhythms — overlap with those of many other heart-related conditions.
• Though HCM is often benign, it can sometimes lead to more serious complications, such as arrhythmia.
• Not everyone with HCM has symptoms, but everyone with the condition should have their heart health regularly monitored by a cardiologist.
• HCM is usually a hereditary disease. If you or a family member has a family history of HCM, you should ask your doctor about screening for the condition.