There are Several Treatment Options for the Heart Condition
- There are several treatment options for people with HCM, and the route your doctor recommends will depend on the severity of the disease.
- Drugs such as beta blockers or negative inotropes may be used.
- There are also several surgeries, such as implanting a pacemaker or removing a part of the ventricle, that can be used in certain situations as well.
- A new drug, mavacamten, just received FDA approval to treat HCM last month and has shown promising results thus far.
Hypertrophic cardiomyopathy (HCM) is a heart condition that causes the muscle of the heart to become abnormally thick, which can lead to complications. Because the disease can make it hard for the heart to pump blood, some people will require medical interventions to treat it — and there are many options for that.
Once a diagnosis is established, there are many different treatment approaches your doctor may recommend. For some people, lifestyle adjustments may be enough to get control symptoms and prolong life. For others, doctors may suggest certain drugs, a surgical approach, or a combination of different methods. The treatment route will depend largely on the severity of the disease and the patient’s overall health.
Treating Hypertrophic Cardiomyopathy With Medication
“In some cases, one can use lifestyle modification [in] those that are asymptomatic or less symptomatic,” Dr. Philip Weintraub, a cardiology specialist based in New York, tells SurvivorNet.
“In the more severe cases, one needs to bring in an arsenal of medications. In the past, we’ve use beta blockers, [which] are drugs that block adrenaline from the body, with the thought process being that if you could decrease the contractility of the left ventricle, you will decrease the amount of obstruction that occurs when the blood is being pumped out of the heart.”
Dr. Weintraub also pointed to another type of drug called negative inotropes, which can be used to decrease the workload of the heart by decreasing the strength of the heart’s contraction.
“The theory behind them is that if you could make the heart function at a decreased rate, then you’re going to wind up with less obstruction,” he explains.
Treating HCM With Surgery
HCM may be treated with a surgical option called a septal myectomy, which is meant to thin out the wall between the left and right side of the heart. “You’d have to surgically enter the left ventricle and carve out the area of the ventricle that’s causing this particular problem,” Dr. Weintraub explains. Because this is an open heart surgery, it’s important to discuss the risks vs. benefits of this procedure with your doctor beforehand.
There are also minor procedures, that may not require a surgeon, that can treat the disease. One of those options is implanting something called a pacemaker, a device that can help the heart to pump blood.
Pacemakers “reside on the right side of the heart [and] will force the septum to move with the right side of the heart,” Dr. Weintraub explains. “So, there’s less interference with the contractility and the ejection of the blood from the left ventricle.”
Your doctor may also recommend something called alcohol septal ablation, which can be used to thin the heart’s thickened septum. “The belief is that the alcohol will cause the heart muscle to die,” Dr. Weintraub explains. “So it won’t be allowed to express itself in the outflow tract.”
New Treatments for Hypertrophic Cardiomyopathy
In April, the Food and Drug Administration (FDA) approved a new treatment called mavacamten for people with certain types of obstructive HCM.
“Mavacamten is an agent that will reprogram the muscle fibers of the heart,” according to Dr. Weintraub. “These are the muscle fibers, and they will downscale them to the point where they don’t produce as much muscle, which is contrary to what is necessary and what develops in hypertrophic cardiomyopathy.
“The drug has been studied and it appears to be quite effective in improving the quality of life where people who experience heart failure generally can move to a lower class in terms of how symptomatic they are.”
Trial & Error
The recent FDA approval is for people with symptomatic New York Heart Association (NYHA) class II-III obstructive HCM. The NYHA class system provides a simple way to classify the extent of heart failure by breaking down severity into four categories. Category I is for patients who have very little or no symptoms, while IV is for people who experience extreme symptoms, limiting their everyday abilities.
Dr. Weintraub explains that research on the new drug shows that it is generally well-tolerated, but HCM patients need to be mindful of side effects and drug interactions.
“It’s fairly well-tolerated, but one must be careful to realize concomitant diseases in the body and also to protect against drug interactions,” he says. “You do not want to take one thing, make it better, and at the same time, take something else and make it worse, so a lot of it is through trial and error and titrating doses up to an acceptable level.”
Questions to Ask Your Doctor
- Does my HCM require treatment?
- What kind of lifestyle adjustments should I make?
- How is my disease classified?
- Should I consider medication or surgery?
Learn more about SurvivorNet's rigorous medical review process.
There are Several Treatment Options for the Heart Condition
- There are several treatment options for people with HCM, and the route your doctor recommends will depend on the severity of the disease.
- Drugs such as beta blockers or negative inotropes may be used.
- There are also several surgeries, such as implanting a pacemaker or removing a part of the ventricle, that can be used in certain situations as well.
- A new drug, mavacamten, just received FDA approval to treat HCM last month and has shown promising results thus far.
Hypertrophic cardiomyopathy (HCM) is a heart condition that causes the muscle of the heart to become abnormally thick, which can lead to complications. Because the disease can make it hard for the heart to pump blood, some people will require medical interventions to treat it — and there are many options for that.
Once a diagnosis is established, there are many different treatment approaches your doctor may recommend. For some people, lifestyle adjustments may be enough to get control symptoms and prolong life. For others, doctors may suggest certain drugs, a surgical approach, or a combination of different methods. The treatment route will depend largely on the severity of the disease and the patient’s overall health.
Treating Hypertrophic Cardiomyopathy With Medication
Read More “In some cases, one can use lifestyle modification [in] those that are asymptomatic or less symptomatic,” Dr. Philip Weintraub, a cardiology specialist based in New York, tells SurvivorNet.
“In the more severe cases, one needs to bring in an arsenal of medications. In the past, we’ve use beta blockers, [which] are drugs that block adrenaline from the body, with the thought process being that if you could decrease the contractility of the left ventricle, you will decrease the amount of obstruction that occurs when the blood is being pumped out of the heart.”
Dr. Weintraub also pointed to another type of drug called negative inotropes, which can be used to decrease the workload of the heart by decreasing the strength of the heart’s contraction.
“The theory behind them is that if you could make the heart function at a decreased rate, then you’re going to wind up with less obstruction,” he explains.
Treating HCM With Surgery
HCM may be treated with a surgical option called a septal myectomy, which is meant to thin out the wall between the left and right side of the heart. “You’d have to surgically enter the left ventricle and carve out the area of the ventricle that’s causing this particular problem,” Dr. Weintraub explains. Because this is an open heart surgery, it’s important to discuss the risks vs. benefits of this procedure with your doctor beforehand.
There are also minor procedures, that may not require a surgeon, that can treat the disease. One of those options is implanting something called a pacemaker, a device that can help the heart to pump blood.
Pacemakers “reside on the right side of the heart [and] will force the septum to move with the right side of the heart,” Dr. Weintraub explains. “So, there’s less interference with the contractility and the ejection of the blood from the left ventricle.”
Your doctor may also recommend something called alcohol septal ablation, which can be used to thin the heart’s thickened septum. “The belief is that the alcohol will cause the heart muscle to die,” Dr. Weintraub explains. “So it won’t be allowed to express itself in the outflow tract.”
New Treatments for Hypertrophic Cardiomyopathy
In April, the Food and Drug Administration (FDA) approved a new treatment called mavacamten for people with certain types of obstructive HCM.
“Mavacamten is an agent that will reprogram the muscle fibers of the heart,” according to Dr. Weintraub. “These are the muscle fibers, and they will downscale them to the point where they don’t produce as much muscle, which is contrary to what is necessary and what develops in hypertrophic cardiomyopathy.
“The drug has been studied and it appears to be quite effective in improving the quality of life where people who experience heart failure generally can move to a lower class in terms of how symptomatic they are.”
Trial & Error
The recent FDA approval is for people with symptomatic New York Heart Association (NYHA) class II-III obstructive HCM. The NYHA class system provides a simple way to classify the extent of heart failure by breaking down severity into four categories. Category I is for patients who have very little or no symptoms, while IV is for people who experience extreme symptoms, limiting their everyday abilities.
Dr. Weintraub explains that research on the new drug shows that it is generally well-tolerated, but HCM patients need to be mindful of side effects and drug interactions.
“It’s fairly well-tolerated, but one must be careful to realize concomitant diseases in the body and also to protect against drug interactions,” he says. “You do not want to take one thing, make it better, and at the same time, take something else and make it worse, so a lot of it is through trial and error and titrating doses up to an acceptable level.”
Questions to Ask Your Doctor
- Does my HCM require treatment?
- What kind of lifestyle adjustments should I make?
- How is my disease classified?
- Should I consider medication or surgery?
Learn more about SurvivorNet's rigorous medical review process.