Although many children don’t experience any symptoms, hypertrophic cardiomyopathy can significantly impact the how the heart pumps blood as the heart muscles thickens from the disease. Once diagnosed, hypertrophic cardiomyopathy can typically be managed to alleviate symptoms and prevent cardiac arrhythmias that can threaten your child’s life.

Wellness & Prevention

Divided into four chambers, the heart muscle makes coordinated contractions dozens of times each minute to take returning blood from the body, send it to the lungs for oxygen and back to the body through the aorta. With hypertrophic cardiomyopathy, the heart muscle that forms these chambers thickens, swelling into the chamber, growing stiff, obstructing the flow of blood and impacting how efficiently the heart pumps. Hypertrophic cardiomyopathy often affects the wall between the lower chambers (ventricles) of the heart.

Hypertrophic cardiomyopathy can be caused by an abnormal arrangement of muscle cells or genetic mutations. Children with parents or siblings who have hypertrophic cardiomyopathy are at a much higher risk of developing the condition.

Without treatment, hypertrophic cardiomyopathy can trigger serious damage in the heart, including:

  • Harming electrical cells. An electrical conduction system sends signals to the heart to keep it in rhythm and contracting in the proper sequence. Thickened muscles can affect how the heart conducts electricity and may cause an abnormal rhythm called an arrhythmia.
  • Obstructed blood flow. Thickened muscles take up more space and may obstruct the flow of blood through the heart or affect the pressure, signaling the valve to close too soon. The heart has to work harder to compensate for the narrower path. Your child could develop congestive heart failure if the heart becomes so overworked that it begins to fail and blood backs up.
  • Damaging heart valves. As the ventricle strains to pump blood with thickened muscle, blood may travel through valves more forcefully and the mitral valve between the left atrium (upper chamber) and the left ventricle may not be able to close properly. As a result, blood can leak backward.

Most children with hypertrophic cardiomyopathy don’t have any symptoms. If symptoms are noticeable, they may be present when your child participates in physical activities or exercises. Symptoms may include:

  • Shortness of breath
  • Chest pain
  • Chest tightness or pressure
  • Fainting, dizziness or lightheadedness
  • Heart murmur
  • Sensation of palpitations
  • Rapid, pounding heartbeat

Diagnosis

Pediatric cardiologists can run several tests to help diagnosis hypertrophic cardiomyopathy.

  • Electrocardiogram (ECG or EKG): Electrocardiograms measure the heart’s electrical activity through electrodes placed on the chest, arms and legs. An ECG can show stress on the heart and abnormal rhythms. An ECG can also be done when a child is exercising on a treadmill or stationary bike to see how the heart functions under stress.
  • Echocardiogram: Using an ultrasound, an echocardiogram produces an image of the heart and evaluates the structure and function of the heart.
  • Holter monitor or event: Electrodes are attached to the chest to take an ECG recording and the child goes about his day while his heart activity is recorded over 24 hours or longer.

Treatments

Treatment plans for hypertrophic cardiomyopathy can vary based on your child’s age, health, the level of disease and the prognosis. Treatments your pediatric cardiologist may recommend include:

  • Medication: Your child’s doctor may prescribe medications to lower your child’s blood pressure, help the heart muscle relax and slow a fast heartbeat. These medications can help the heart pump blood more efficiently and prevent abnormal rhythms.
  • Implantable cardioverter defibrillator: A cardioverter defibrillator can be implanted in the chest to track the heart rate. If the heart goes into a dangerously fast rhythm, the device sends an electrical shock that can be uncomfortable but may save your child’s life by stopping the rhythm.
  • Surgery: Utilized only in severe cases, a pediatric cardiac surgeon removes the portion of diseased muscle to improve the flow of blood through the heart.
  • Heart transplant: In rare cases, your child’s pediatric cardiologist may recommend a heart transplant to replace your child’s diseased heart.

Aftercare

Most children with hypertrophic cardiomyopathy go on to lead active, healthy lives after treatment. Your pediatric cardiologist may recommend limiting your child’s participation in specific sports and physical activities to protect his heart. Even with treatment, your child may need to take medication and will likely need to see a cardiologist for the rest of her life to monitor the health of her heart and check on the cardioverter defibrillator if one was implanted.