Hypertrophy Obstructive Cardiomyopathy (HOCM) & its Cardiac Effect By Dr. Subhendu Mohanty

HOCM or Hypertrophic obstructive cardiomyopathy consequence in unusual thickening of the myocardium, generally in the interventricular septum, with pathologic “myocardial disarray” upon microscopic inspection. It can lead to life-threatening arrhythmias, clinical heart failure, mitral regurgitation, and sudden cardiac death.


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HOCM is a genetic disorder in around 60% of cases. The remainder is related to instant mutations. Various different genes are involved that can result in HOCM.


What are the Symptoms Hypertrophic Obstructive Cardiomyopathy?


Symptoms of hypertrophic cardiomyopathy can include:


  • Shortness of breath, especially during exercise



  • Fainting, especially exercise or exertion


  • A sensation of rapid, fluttering heartbeats (palpitations)


  • Heart murmur, which doctor can detect while examining the heart.


If you are feeling any of the above symptoms then consult a cardiologist as soon as possible.



Cardiac Effects in HOCM:


In hypertrophic obstructive cardiomyopathy, the muscular walls of the ventricles become thickened – a condition called “hypertrophy.” This thickening can lead the heart muscle to work abnormally, to at least some extent. If severe, hypertrophy can lead to cardiac arrhythmias and heart failure.


HOCM can lead to different five kinds of serious cardiac problems like:



Diastolic Dysfunction:


Diastolic dysfunction is an unusual stiffness of the ventricular muscle, that makes it difficult for the ventricles to provide the blood in between each heartbeat as required.


If severe enough, It can lead to diastolic heart failure, and severe symptoms are shortness of breath and fatigue. Even relatively mild diastolic dysfunction makes it more difficult for patients with HCM to tolerate cardiac arrhythmias, especially atrial fibrillation.


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Left Ventricular Outflow Obstruction. (LVOT)


In LVOT, there is a partial barrier for making difficult for the left ventricle to excrete its blood with each heartbeat. This problem also happens with aortic valve stenosis, in which the aortic valve becomes thicken and fails to open usually.


Mitral Regurgitation


In mitral regurgitation, the mitral valve fails to close generally when the left ventricle beats, allowing blood to flow at the reverse side into the left atrium.


Ischemia of the Heart Muscle


Ischemia which is also known as oxygen deprivation, it is most typically seen in patients with coronary artery disease (CAD), in which a blockage in a coronary artery limits the flow of blood to a particular part of the heart muscle.


Sudden Death


Sudden death in HOCM is usually due to ventricular fibrillation or ventricular tachycardia and is typically related to extreme exertion. It can lead to oxygen deprivation of the heart muscle produces many if not most of the shortness of breathing that leads to sudden death in patients with HCM.


Prevention of Sudden Death


HCM is the most common cause of sudden death in young especially in athletes While sudden death is always a destructive problem, especially, when it occurs in young people. Due to this, extreme exertion and exercise should be restricted in patients who are dealing with HOCM.


Well, many methods tried for the reduction the risk of sudden death in patients with HCM like using beta blockers and calcium blockers, and antiarrhythmic drugs.



However, these methods have not proven sufficiently effective. It now seems clear that, in patients with HCM whose risk of sudden death appears high, an implantable defibrillator should be strongly recommended.


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About Dr. Subhendu Mohanty: Doctor Subhendu is a well-known cardiologist in Noida If you feel any symptoms of the HOCM disease or any other heart problem you can book a free appointment and consult to the doctor.


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