8 symptoms of obstructive and non-obstructive HC and what this disease is

Hypertrophic cardiomyopathy (HC) is a serious heart disease. It is characterized by the presence of severe left ventricular myocardial hypertrophy. In most cases, the disease is asymptomatic, but without timely detection, complications are possible that lead to the death of the patient. Therefore, it is important to familiarize yourself with the main features of HA and effective preventive methods.

What is hypertrophic cardiomyopathy?

Initially, it should be noted that in cardiology, there are two types of cardiomyopathies: primary (hypertrophic, constructive, dilated, restrictive and arrhythmogenic) and secondary (alcoholic, toxic, metabolic and other specific subspecies).

Hypertrophic cardiomyopathy is a subtype of the primary species. It is an independent disease, which does not always depend on the presence of other problems with the cardiovascular system.

• the myocardium of the left ventricle thickens (rarely the right one);
• the cavity of the ventricle is significantly reduced in size;
• diastolic function is disturbed → heart rhythm failures are traced;
• heart failure occurs.

These deviations do not always affect the general well-being of a person. There are times when the life of the patient is in danger (due to the neglect of the disease), and he does not even suspect it.

According to statistics, GC develops in approximately 0.8-1% of the people of the entire planet. Most of the patients are men of mature age (35-50 years).

Many medical professionals say that GC can be attributed to a number of family diseases. Hypertrophic cardiomyopathy is in the top cardiovascular diseases that are inherited.

The effect of sudden death, which can be traced in athletes under 35 years of age, as a rule, is a consequence of the impact of this pathology.

The disease can cause additional heart problems. In more than 20% of all cases, patients begin to develop coronary atherosclerosis. Severe ventricular arrhythmia is the result of GC. Almost 50% of people with ventricular tachycardia have cardiomyopathy. Delays in providing medical care can lead to death.

In patients with this disease, complications in the form of infective endocarditis can be traced. In this case, the mitral and / or aortic valve is affected. The percentage of people with a similar problem varies from 5 to 10. Most often men suffer after 30 years.

GC is also found in children. It can manifest itself in a child of any age, even in a newborn, especially if the disease was inherited from the parents. If there is a suspicion that the child could get such a pathology, it is better to immediately consult a doctor.

Classification and forms of the disease

To date, the division of hypertrophic cardiomyopathy into types and forms depends on various factors. Therefore, there is not one classification, but several at once.

In the course of the disease, the heart muscle tends to increase symmetrically or vice versa.

• symmetrical. It is characterized by the same thickening of the walls of the left (rarely right) ventricle. The thickness increases gradually and symmetrically. Concentric symmetrical cardiomyopathy may be seen. In this case, the thickening occurs evenly around the circle.
• asymmetric. Most patients (68-70%) have this form of the disease. Thickening occurs, as a rule, in the region of the interventricular septum, as well as in the lower third. Usually the septum increases by 2-3 times. The back wall undergoes changes extremely rarely. It is customary to highlight the apical form. This means that the muscle only changes in size at the top of the heart.

• obstructive;
• non-obstructive.

Hypertrophic cardiomyopathy with outflow tract obstruction is characterized by impaired blood flow due to severe thickening of the heart muscle. This form was given another name - subaortic subvalvular stenosis. In turn, the non-obstructive form of pathology does not interfere with normal blood flow in the body at all.

• primary. They are also called idiopathic. The main reason for their appearance is the transfer of genes that have been changed or have become the result of a random mutation.
• secondary. They occur when the structures of the heart undergo changes in subsequent periods in the development of the human organism. They can also be the result of an underlying serious heart condition.

The degree of thickening of the myocardium also influences the form of HA.

• moderate (is 15-20 mm);
• medium (21-25 mm);
• pronounced (more than 25 mm).

Some doctors tend to classify cardiomyopathy and depending on the degrees, as indicated above, since the thickness of the walls directly affects the further course of the disease.

It is important to pay attention to the clinical and physiological factor.

1. In the outflow tract of the left ventricle (LVOT), the pressure gradient does not exceed 22-25 mmHg. This stage does not bother the patient, since there are no visible symptoms. Good health is maintained. There are no complaints.
2. The same region of the heart has a pressure gradient of no more than 36 mm Hg. The patient does not yet observe serious deviations. There may be discomfort during physical exertion. Regular sports activities can cause discomfort in the chest.
3. The gradient is no more than 44 mmHg. Symptoms of angina pectoris are periodically traced. A person may experience shortness of breath even at rest, including during rest.
4. Pressure gradient - from 80 mm of mercury and more. The process of hemodynamics (the movement of blood through the vessels) is disturbed. All the symptoms that were previously indicated are preserved. At this stage, the possibility of a sudden death effect rapidly increases.

• a sharp increase in pressure during physical exertion;
• frequent fainting for no apparent reason (especially at a young age);
• arrhythmia, high heart rate;
• heredity (if someone in the family has already died due to GC);
• poor indicators of cardiac function;
• the appearance of a huge number of symptoms of the disease.

People who have the above problems, experts recommend that you constantly see a doctor. An early diagnosis can save a life.

The main causes and symptoms of the disease

Hypertrophic cardiomyopathy is familial, meaning it is usually inherited. This is one of the main reasons for the appearance of this deviation in many people.

The defective genes that cause heart problems code for the synthesis of myocardial contractile protein. In the future, they can mutate under the influence of various external factors.

Pathology is not associated with other congenital or acquired diseases of the cardiovascular system (heart disease, hypertension).

It is worth noting that in the initial stages of the disease, a person practically does not come across unpleasant symptoms. The so-called clinical manifestation (the manifestation of pronounced clinical features after a calm course of the disease) is most often observed at the age of 25-40 years.

For the most part, the symptoms depend on the form of the disease. If during non-obstructive cardiomyopathy discomfort may not occur at all, then the obstructive type of pathology entails a number of unpleasant sensations, since the blood flow in this case is disturbed.

In the later stages of the disease, many visible manifestations may appear, which will be inherent in other diseases of the cardiovascular system. Therefore, you need to be attentive to your health and attend special examinations with a doctor.

• shortness of breath (appears due to increased diastolic filling pressure in the ventricle (left); pressure in the veins of the respiratory system increases, after which the gas exchange process is disturbed);
• anginal pains (pressing pains in the chest area; the result of a lack of oxygen for the full functioning of the myocardium);
• dizziness, a feeling of fainting (they are a consequence of arrhythmia or circulatory disorders in the brain; it usually appears during physical exertion);
• arterial hypotension (a sharp decrease in blood pressure, which leads to fatigue, drowsiness, violation of temperature regimes, periodic visual impairment);
• problems with the rhythm of the heart (rapid heartbeat; ventricular and supraventricular tachycardia is the cause of such a symptom);
• cardiac asthma and pulmonary edema (they are forms of complications; they strongly affect the general condition of the body);
• cyanosis (cyanosis; bluish extremities and / or mucous membranes; visible with heart failure);
• systolic murmur (best seen in the area where the apex of the heart is).

Diagnostic methods

Diagnosis of hypertensive cardiomyopathy, like other diseases, begins with a general examination by a doctor. Initially, the specialist listens to the person's complaints and gathers information about their family history. Be sure to determine when the first symptoms appeared, and how the patient's condition changed over time. A thorough analysis of the diseases that a person has come across before, and what diseases have been traced in his close relatives, is also carried out. The initial diagnosis is made after a physical examination.

Physical examination - a set of medical measures necessary for the diagnosis. All methods are used exclusively by a doctor. For diagnosis, he uses the senses.

Initially, skin color should be assessed, since with GC some parts of the body (especially the limbs and mucous membranes) turn blue. The next step will be tapping, which will help determine whether the enlarged heart is really on the left side. This is followed by auscultation (listening to the work of internal organs). It reveals the presence of systolic murmurs near the aorta. If a specialist detects them, it means that the cavity of the ventricle is gradually narrowing.

1. Testing (blood, urine). The results will provide information about the general condition of the patient's body.
2. Blood chemistry. It is necessary to determine indicators that can indicate the presence of affected organs.
3. Coagulogram. Provides all the necessary information about blood clotting.
4. Phonocardiogram. The study can clearly show the presence of systolic murmurs over the aorta.
5. ECG (electrocardiography). Helps make sure the ventricles are enlarged.
6. Chest x-ray. This method will show the actual size of the heart, and also indicate blood stasis in the lungs, if any.
7. MRI (magnetic resonance imaging). The method makes it possible to examine the internal organs and tissues of the human body. This way you can get an accurate image of the heart muscle.
8. EchoCG (echocardiography). Ultrasound of the heart. With its help, the dimensions of the cavities of the organ, the thickness of its muscles are estimated.

The patient is recommended to consult a general practitioner and a cardiac surgeon. The formulation of the final result also depends on these specialists.

Treatment

Treatment of hypertrophic cardiomyopathy requires special attention. For the most part, it takes place outside a stationary institution, and therefore needs an integrated approach to solving the problem.

A good specialist will initially set a number of goals, the achievement of which will be given time. First, you need to reduce the manifestation of symptoms, thereby improving the patient's condition. Secondly, try to prevent a further increase in cardiomyopathy, or at least reduce its severity. Thirdly, deal with the treatment of complications, if any, and also draw the attention of the patient to preventive measures that will help avoid sudden death.

Theoretically, treatment can be divided into three categories: therapeutic, medical and surgical.

Therapeutic

The main therapy is aimed at improving the patient's lifestyle, as well as making a rational diet. Physical activity is minimized, as there is a danger of a significant deterioration in well-being. An increased pressure gradient between the aorta and the left ventricle should be avoided. It is not worth making a schedule of sports activities and a diet without a doctor.

Medical

Treatment involves the use of medications to restore the full functioning of the cardiovascular system. The choice of the drug depends purely on the individual characteristics of the person, as well as his performance after all studies.

For treatment are used:

• beta-blockers (help to normalize the heart rate);
• calcium antagonists (increase blood flow).

With drug therapy, it is advised to take drugs designed to prevent thromboembolism.

Drug therapy begins with the introduction of minimal doses of the drug. The doctor should monitor the body's response to treatment, and increase doses over time if necessary.

Operating

Surgery can also be performed if the attending physician has conducted all the necessary studies and found no contraindications.

Women who suffer from hypertrophic capdiomyopathy are prohibited from performing any operations during pregnancy.

If you do not pay due attention to treatment, the likelihood of death is much higher. According to statistics, 3-8% of patients with GC die due to late visits to the doctor.

Preventive activities

Prevention of GC does not have a large list of recommendations, since it does not require specific actions.

There are several standard tips that will help you detect the problem in time, if any, and also create living conditions to avoid possible problems with the cardiovascular system:

1. Take time for periodic medical examinations if relatives have already had cases of the onset of this disease. Keep records, which in the future can help the doctor quickly determine the form of the disease and prescribe the necessary course of treatment.
2. Follow a special diet, which includes food with a minimum addition of salt and spices. Also in the diet, the amount of fatty foods that can increase blood cholesterol levels is reduced. Eating food that is rich in vitamins and minerals helps keep the body in good shape.
3. Give the body a good rest after a hard day. Mental stress can negatively affect the work of the heart.
4. Serious physical activity is contraindicated. But you don't have to give up sports completely.
5. Give up bad habits that have a negative impact on the functioning of body systems (smoking, drinking alcohol and drugs, sleepless nights).

You need to visit a cardiologist and a therapist every six months. Counseling should be scheduled for all family members, including children.

If a person already suffers from hypertrophic cardiomyopathy, he is advised to remain calm. Physical activity in this case is minimized to avoid further complications.