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The symptoms of hypertrophic cardiomyopathy (HCM) can make daily life much harder. Chest pain, dizziness, shortness of breath (especially during or after activity), or palpitations (fluttering sensations in the chest) can be disruptive. If symptoms don’t improve with other treatments, surgery may be an option.
It’s entirely normal to experience anxiety, fear, or stress about having heart surgery. However, with the proper support, you can successfully recover from surgery and experience a better quality of life. Learn more about the different surgeries and procedures that can treat HCM.
HCM causes the heart muscle to become enlarged and stiff, so it can’t pump blood as well as it should. Therefore, the heart can’t consistently deliver enough blood throughout the body. Most individuals with HCM take medications to help their heart pump more effectively, which can control their symptoms. However, about 50 percent of people with HCM will continue to have symptoms that disrupt their daily lives. For these individuals, surgical procedures may be an option.
About 1 in 15 people with HCM will develop heart failure. Having heart failure means that your heart muscle is weak and cannot pump effectively. If you develop heart failure with HCM, you may need surgery for treatment.
If you have HCM and your symptoms are not well controlled with medication and lifestyle changes, your heart specialist may recommend one of the following procedures. The treatment option that works for one individual may not be the right choice for someone else, so your cardiologist will guide you in making the decision that’s best for you.
Abnormal and potentially dangerous arrhythmias (heart rhythms) are typical in HCM. The most dangerous arrhythmias are ventricular tachycardia (VT) and ventricular fibrillation, life-threatening rhythms that occur in the lower chambers of the heart (ventricles). Arrhythmias can lead to sudden cardiac death, which occurs in 0.7 percent to 1 percent of people with HCM every year.
An implantable cardioverter-defibrillator (ICD) can treat arrhythmias and prevent sudden cardiac death, also called cardiac arrest. ICDs continuously monitor the heart rhythm and deliver an electrical shock when necessary to restore a normal rhythm. An ICD is usually implanted by an interventional cardiologist in a minimally invasive procedure that does not require open-heart surgery.
“I’ve had an ICD for nine years. It saved my life twice,” a MyHeartDiseaseTeam member said.
Alcohol septal ablation is one treatment option for HCM that’s minimally invasive. The goal is to reduce the thickness of the septum, or the large muscle that separates the ventricles.
During this procedure, a heart specialist guides a flexible tube called a catheter through a large blood vessel in your groin to the artery that supplies blood to the septum. Next, the healthcare provider injects alcohol into that artery, causing the damaged heart muscle to shrink and become unable to contract. Alcohol septal ablation will not harm the rest of the functioning heart tissue.
When alcohol septal ablation is successful, the septum becomes smaller, and there’s more room for blood to flow through the heart. Therefore, the heart can pump more blood with each contraction, improving circulation through the body.
A septal myectomy is a surgical procedure in which a surgeon removes some of the extra, thickened muscle of the septum. As with an alcohol septal ablation, the goal is to reduce the amount of space that the enlarged septum is taking up within the heart, allowing more blood to flow through. Unlike septal ablation, though, septal myectomy is an open-heart surgery, so recovery takes longer. However, septal ablation has a higher risk of certain complications, including abnormal heart rhythms. Talk to your doctor to decide on the best option for you.
A ventricular assist device (VAD) is a surgically implanted, external device that draws blood from the lower chambers of the heart into an external pump. This pump circulates blood when the heart is too weak to pump effectively on its own. VADs are rarely used for treating HCM, but the device can treat advanced cases of heart failure. In some cases, they may be used as a temporary measure while someone is awaiting a heart transplant.
VADs must be plugged into an electrical outlet or attached to a rechargeable battery while you are away from home. Therefore, a person with a VAD must have consistent access to electricity and a backup power plan for times when power may be unavailable.
If you develop heart failure and you don’t respond to any other treatments, you may be a candidate for a heart transplant. During a heart transplant, your heart is removed and replaced with a new heart from a suitable donor.
To decide if you qualify for a heart transplant, you’ll need a thorough transplant evaluation, which includes:
If you’re a candidate and on the waiting list for a heart transplant, you’ll need to be available by phone at all times. A donor heart must be transplanted within six hours, so once you get the call that a heart is available, you will need to get to the hospital quickly.
After a heart transplant, you’ll need to be on antirejection medications, drugs that prevent your immune system from rejecting your new heart. Your doctor will monitor you frequently to make sure you are receiving the correct dose. Because antirejection medications suppress your immune system, you will be at greater risk for infections, so you should avoid crowded environments and being around anyone who has had a recent infection.
Your recovery time will depend on the procedure you had and whether you experienced any complications. Before you leave the hospital, your care team will provide detailed discharge instructions, including any activity restrictions you’ll need to follow, when you can resume daily activities, and when to see your doctor.
After your surgery or procedure, you may qualify for cardiac rehab. Cardiac rehab programs help you strengthen your heart, get back into a regular exercise routine, and learn healthy lifestyle habits that benefit your heart. During cardiac rehab sessions, you will exercise under medical supervision. You’ll also receive education on a heart-healthy diet, stress reduction, and how to quit tobacco products, if you use them.
Cardiac rehab also serves as a support group where you can meet others experiencing similar issues.
“Cardiac rehab is beneficial,” said a MyHeartDiseaseTeam member. “You will meet and enjoy sharing experiences and challenges with the folks within your group. You will laugh together and show concern for one another. I found cardiac rehab to be very rewarding.”
If you have an incision, keep an eye out for signs and symptoms of wound infection, like:
Let your doctor know if you experience any of the following symptoms:
On MyHeartDiseaseTeam, people share their experiences with heart disease, get advice, and find support from others who understand.
If you’ve had surgery for HCM, what was your experience like? Let others know in the comments below.
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