HCM and YOUR Fitness
When a diagnosis of HCM is made, there is often a great deal of confusion on the topic of exercise. Some patients are told “do not do anything physical,” while others are told “do whatever you want”. Experts would likely agree on one thing – those approaches are both wrong and the best advice likely falls somewhere in the middle.
We know a great deal about HCM, but we still have a lot to learn. The current guidelines are helpful, yet still a little confusing. The AHA/ACCF Guidelines on HCM state a “large proportion of patients presenting with HCM are asymptomatic, and most will achieve a normal life expectancy. It is essential to educate these patients and their families about the disease process, including screening of first-degree relatives and avoiding particularly strenuous activity or competitive athletics. ”
Later in the document it is a bit more specific on the issue of young competitive athletes.
“A number of large cohort studies from the United States indicate that HCM is the most common cardiovascular cause of SCD in young athletes, accounting for about one third of these events. The American College of Cardiology Bethesda Conference No.36 as well as the European Society of Cardiology guidelines indicate that risk for SCD is increased during intense competitive sports and also suggest that the removal of these individuals from the athletic arena can diminish their risk. This principle is the basis for disqualification of athletes with HCM from sanctioned high school and college sports. It should be underscored that these consensus recommendations for competitive athletes are independent of those for noncompetitive, informal recreational sporting activities.”
The question of a general exercise or fitness plan is still a bit more unclear to most. Research is underway to give better guidance and clinically based recommendations. To participate in this research, please visit this link to learn more about LIVE-HCM.
The guidelines specially address exercise in the asymptomatic HCM patient:
“Class IIa 1. Low-intensity aerobic exercise is reasonable as part of a healthy lifestyle for patients with HCM.”
However, for the symptomatic HCM, which is the majority of those with HCM, it is less clear as to the best approach. It is advised you work with your individual physician to determine what level of fitness is appropriate for you. Those with obstructive HCM may need to avoid strenuous activity until which time the obstruction has been addressed – medically, surgically or via alcohol septal ablation.
There is, however, a new alternative plan created by Canadian HCM specialist Dr. Harry Rakowski, Holistic Lifestyle Coach Sarah Harris, Cardiologist Dr. Gillian Nesbitt, and athletic specialist Ryan Burkholder. This new and unique program has 3 levels including Beginner, Intermediate and Advanced. Their website is designed to show you how to maintain heart health through step-by-step videos, key medical information, and a proven exercise program. Blending the best in cardiac medicine with the latest fitness practices, they have designed a safe and effective series of exercises that can be done individually or as part of a program. Created specifically for hypertrophic cardiomyopathy (HCM) patients, the Beginner, Intermediate or Advanced HCM programs can be followed by anyone seeking to improve their overall fitness. The HCMA is happy to provide this link to invite you to try this holistic approach to exercise created to promote well-being, resilience to stress, and a happy, healthy heart.