Condition Progression Guide
Hypertrophic Cardiomyopathy
HCM management during this stage involves regular monitoring of the heart. Guidelines from the American Heart Association and the American College of Cardiology recommend that people without symptoms receive monitoring every 1 to 2 years.
Stage 1: Nonhypertrophic
Stage 2: Classic phenotype
Stage 3: Adverse remodeling
Stage 4: Overt dysfunction
HCM stage 2 is the “classic” presentation of the disease. During stage 2, the heart's left ventricle has begun to thicken, and that thickening may or may not obstruct the left ventricular outflow tract (LVOT). LVOT obstruction reduces the amount of blood the heart can pump out.
At this stage, a person may experience mild or no symptoms, but the heart will pump with excessive force. Management may involve regular monitoring, treatment of LVOT obstruction, and medications to reduce the force of the heart's contractions and the intensity of its pumping.
By stage 3, HCM has caused structural changes within the heart and reduced the amount
of blood it can pump out with each beat.
Management may involve medications and possibly an implantable cardioverter defibrillator (ICD), which can detect and stop irregular
heart rhythms.
Overt dysfunction, also called end stage HCM,
is the final stage of progression. During this stage, a person may experience heart failure, irregular heart rhythms, and severe changes
in the heart's ability to contract and relax with each beat.
A person with overt dysfunction may receive heart failure therapy, an ICD, a left ventricular assistive device (which helps the left ventricle pump out blood), or a heart transplant.
During the nonhypertrophic stage, a person carries the gene mutation that causes HCM but shows no signs or symptoms of the condition.
