Asymmetric Septal Hypertrophy

Definition

Definition of Asymmetric Septal Hypertrophy
A disease of the heart muscle characterized by increased thickness of the wall of the heart ventricle which affects the hearts function.

Symptoms

Symptoms of Asymmetric Septal Hypertrophy

1. Chest pain
2. Dizziness
3. Fainting, especially during exercise
4. Heart failure (in some patients)
5. High blood pressure (hypertension)
6. Light-headedness, especially with or after activity or exercise
7. Sensation of feeling the heart beat (palpitations)
8. Shortness of breath

Causes

Causes of Asymmetric Septal Hypertrophy
Hypertrophic cardiomyopathy is often asymmetrical, meaning one part of the heart is thicker than the other parts. The condition is usually passed down through families (inherited). It is believed to be a result of several problems (defects) with the genes that control heart muscle growth.

Younger people are likely to have a more severe form of hypertrophic cardiomyopathy. However, the condition is seen in people of all ages.

Diagnosis

Diagnosis of Asymmetric Septal Hypertrophy
The health care provider will perform a physical exam and listen to the heart and lungs with a stethoscope. Listening with a stethoscope may reveal abnormal heart sounds or a murmur. These sounds may change with different body positions.

The pulse in your arms and neck will also be checked. The doctor may feel an abnormal heartbeat in the chest.

Tests used to diagnose heart muscle thickness, problems with blood flow, or leaky heart valves (mitral valve regurgitation) may include:

1. 24-hour Holter monitor (heart monitor)
2. Cardiac catheterization
3. Chest x-ray
4. ECG
5. Echocardiography (the most common test) with Doppler ultrasound
6. MRI of the heart
7. Transesophageal echocardiogram (TEE)

Treatment

Treatment of Asymmetric Septal Hypertrophy
The goal of treatment is to control symptoms and prevent complications. Some patients may need to stay in the hospital until the condition is under control (stabilized).

If you have symptoms, you may need medication to help the heart contract and relax correctly. Some medications used include beta-blockers and calcium channel blockers, which may reduce chest pain and other symptoms, particularly with exercise. Medications will often relieve symptoms so patients do not need more invasive treatments.

Some people with arrhythmias may need anti-arrhythmic medications. If the arrhythmia is due to atrial fibrillation, blood thinners may also be used to reduce the risk of blood clots.

When blood flow out of the heart is severely blocked, an operation called surgical myectomy may be done. This procedure cuts and removes a portion of the thickened part of the heart. Patients who have this procedure often show significant improvement. If the heart's mitral valve is leaking, surgery may be done to repair or replace the valve.

In some cases, patients may be given an injection of alcohol into the arteries that feed the thickened part of the heart (alcohol septal ablation), essentially causing a controlled heart attack.

Prognosis

Prognosis of Asymmetric Septal Hypertrophy
Some people with hypertrophic cardiomyopathy may not have symptoms and live a normal lifespan. Others may get worse gradually or rapidly. The condition may develop into a dilated cardiomyopathy in some patients.

People with hypertrophic cardiomyopathy are at higher risk for sudden death than the normal population. Sudden death can occur at a young age.

Hypertrophic cardiomyopathy is a well-known cause of sudden death in athletes. Almost half of deaths in hypertrophic cardiomyopathy happen during or just after the patient has done some type of physical activity.

If you have hypertrophic cardiomyopathy, always follow your doctor's advice concerning exercise and medical appointments. Patients are sometimes advised to avoid strenuous exercise.

Prevention

Prevention of Asymmetric Septal Hypertrophy
If you are diagnosed with hypertrophic cardiomyopathy, your health care provider may recommend that your close blood relatives (family members) be screened for the condition.

Some patients with mild forms of hypertrophic cardiomyopathy are only diagnosed by screening echocardiograms because of their known family history.

If you have high blood pressure, make sure you take your medication and follow your doctor's recommendations.