Thickening of the heart muscle caused by high blood pressure

Heart thickening is one of the most common genetic cardiac disorders. On average, 1 in 500 people in the general population of a country is known to suffer from hypertrophic cardiomyopathy.

What is Heart thickening AKA Hypertrophic Cardiomyopathy?

Hypertrophic Cardiomyopathy, commonly referred to as heart thickening occurs due to the thickening of the heart muscle that causes the walls of the ventricles to thicken.

In cases of obstructive hypertrophic cardiomyopathy, the thickening of the heart wall restricts the blood flow out of the heart. Sometimes, the septum tends to stiffen and bulge into the left ventricle. This too impedes blood flow making the ventricle work harder to pump blood out into the body.

This heart ailment can often lead to mitral valve thickening which causes blood to leak backward through the valve. In this case, the blood flow is not obstructed, but the left ventricle becomes unable to relax. This condition of chamber wall thickening is known as non-obstructive hypertrophic cardiomyopathy.

What causes Heart thickening?

The thickening of the heart is hereditary, the main cause being autosomal dominant genetic disorder. Patients suffering from heart thickening often possess an abnormal arrangement of heart muscles or myofiber disarray. The thickening of the heart wall can also occur due to ageing, high blood pressure, diseases of the thyroid gland, and diabetes.

Symptoms to watch out for:

The following symptoms can arise in the case of hypertrophic cardiomyopathy:

  • Shortness of breath especially during exercise
  • Chest pain during exercise or after heavy meals
  • Fainting tendencies, during and after strenuous activities
  • Extreme fatigue
  • Palpitations
  • Heart murmur

Diagnosis:

The thickening of the heart muscle is usually diagnosed based on medical history. The following tests are advised by doctors who show symptoms of thickening of the heart:

  • Physical examinations like blood pressure, heart rate, body temperature, and overall appearance
  • Echocardiogram
  • Blood tests
  • Electrocardiogram
  • Chest X-ray
  • CT scan
  • MRI

Treatment:

After a thorough screening and risk identification, doctors may advise medications or ask patients to go for surgery.

Common medications for heart thickening include beta-blockers and calcium channel blockers that relax the heart muscle, allowing it to pump more efficiently. Cardiologists may prescribe certain other medicines to decrease the occurrence of arrhythmia. May be needed to avoid certain medicines that contain nitrates as they tend to lower the blood pressure.

Does it require Surgery?

Surgery may be advised to patients with serious thickening of the heart but only when medications are not effective. Usually, surgical operations are performed for hypertrophic obstructive cardiomyopathy. The procedures may include:

  1. Septal Myectomy – Removal of a small amount of thickened septal wall to remove the blockage in the passage of blood.
  2. Ethanol Ablation – Cardiac catheterization procedure is carried out in which pure alcohol is used to kill the cells, leading to the walls shrinking back to normal size.
  3. Implantable Cardioverter Defibrillators (ICD) – For high-risk patients who face chances of sudden cardiac arrest.

Lifestyle changes to adopt:

  • Diet – Patients should follow guidelines outlining the intake of alcoholic and caffeinated beverages
  • Non-competitive aerobic exercise can be done
  • Regular follow-up visits to cardiologists to monitor the condition

Heart Thickening FAQs:

  • What causes the thickening of the heart?

Thickening of the heart muscle is inherited but can also occur due to ageing and as a side-effect of coronary heart diseases, diabetes, and thyroid gland disorders.

  • What is the life expectancy of patients suffering from heart thickening? 

Most patients have almost normal life expectancies. Mortality rates are only about 0.5% per year.

  • Is exercise recommended?

Light exercise is always recommended. However, strenuous activities can lead to sudden cardiac arrest. Hence, patients should ask for personalized advice from doctors regarding the limits to physical exercise.

Heart thickening symptoms are often overlooked and can cause sudden cardiac arrests among young people. Even common concerns of the heart should not be ignored and immediate checkup should be done to ensure the healthy, normal functioning of the heart.

Dr. Shakapur Chaudappa, Consultant – Cardiology (Adult), SDM Narayana Heart Centre, Dharwad

How serious is thickening of the heart?

A thickened heart muscle and changes in the structure of heart cells can cause changes in the heart's electrical system, resulting in fast or irregular heartbeats. Atrial fibrillation can also increase the risk of developing blood clots, which can travel to the brain and cause a stroke.

What is the treatment for thickening of the heart?

Alcohol septal ablation (nonsurgical procedure): Ethanol (a type of alcohol) is injected through a tube into the small artery that supplies blood to the area of heart muscle thickened by hypertrophic cardiomyopathy. The alcohol causes these cells to die. The thickened tissue shrinks to a more normal size.

What does it mean when your heart muscle is thickening?

Hypertrophic cardiomyopathy is most often caused by abnormal genes in the heart muscle. These genes cause the walls of the heart chamber (left ventricle) to become thicker than normal. The thickened walls may become stiff and this can reduce the amount of blood taken in and pumped out to the body with each heartbeat.

Does high blood pressure damage heart muscle?

Heart failure. Over time, the strain on the heart caused by high blood pressure can cause the heart muscle to weaken and work less efficiently. Eventually, the overwhelmed heart begins to fail.