Non Obstructed, Concentric HMC

[Bucky]

Since I am a member of two subgroups of HCM...........I would like to hook up with others in the same boat so we can share our experiences with symptoms and treatments. (Maybe nothing symptom-wise or treatment-wise is different than the entire HCM population, but I am curious)

So any of you who are non-obstructed and who have received the diagnosis of concentric HCM, let me know who you are so we can share some info.

Let me know on this thread, or if you wish you can send me a message via this community board messaging feataure and I'll get back with you.


just call me curious,





Doug (aka bucky)

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[Pam Alexson]

Well if it's any comfort to you...I used to be asymetrical obstructed HCM and now, 5 years post myectomy I am, non-obstructed , mildly concentric HCM. Of course to me that could mean that my heart walls are thinning and I am beginning to dilate... then again I would leave you and join a new category; the dilated. Hopefully I will stay in this group with you. BTW we are not in the majority. Most HCMers are asymetrical and then there is the 25% who are obstructed as well.

I think you will see that a lot of the discussion about asymetrical VS concentric is predominantly speaking about the septal thickness. Some individuals seem to have generalized heart thickness as well in a concentric pattern or it may be in some areas of the walls and not others( asymetric) But more specifically around that bump on the septum that leads them to septal surgery or ablation. The talk is generally focused on : asymetrical vs concentric; operative or non operative.

At one point and even amongst a lot of doctors still they believe that concentric thickening( LVH) was and is what exclusively happened in hypertensive heart disease patients VS a genetic heart disease ( HCM ).. the obstructive part( the 25%) may have been thought to occur over long term hyperdynamic functioning and compensation of the heart pappilary muscle.

One snipet of information I hold steady to is what an expert told me when I had been falsely put in the LVH category and not where I belonged with the HCMers is that it would take about 20 years of untreated hypertension to cause the damage to occur that is evident by your diastolic heart failure and the huge dynamic obstructive gradient (240mmHG). My hypertension was a fact by early 40's but it was treated successfully and at early onset at that time. I was always compliant and my BP readings w/ medication were excellent.

I think this sort of thinking is what has kept a lot of doctors from referring patients to specialty HCM centers and doctors. They are still in the belief THAT IT MUST BE EXCLUSIVELY FROM HYPERTENSION. It is still difficult to sort through but nonetheless the treatment should paralell what HCM doctors offer their patients.

It is sort of like heart failure ..where ever / however it originated HF needs to be treated as HF.

I know this is off from your original quest for friends in your category..but you know me.. have to take advantage of an opportunity to educate about HCM.

Pam

[Bucky]

Thanks Pam.....

A question. When you talk about long term hypertension, I am assuming you are talking about the kind of high BP that would show up in your annual physicals. Isn't there another high BP problems between your heart and lungs that doesn't show up as High Blood Pressure on a normal BP (cuff) test?

Doug

[Pam Alexson]

I think you are referring to pulmonary hypertension? Measured by heart catheterization and estimated on echocardiography.

Over time the increased intracardiac pressures( caused by obstructions to name one cause and stiff filling, poorly relaxed left ventricle another cause, can result in pulmonary hypertension). There are also other factors that can cause PH and with HCM it is usually referred to as Secondary PH ; because it came as a result of the hypertrophic cardiomyopathy. You are correct though the person who has hypertension long term and not well controlled also runs the risk of getting Secondary PH and right, you cannot put a cuff around the lung LOL.

Increased intracardiac pressures lead to dilation of the left atria and onset of atrial fibrillation as well.

Elevated right heart pressures contribute also and lead to dilation of the inferior vena cava and systolic heart failure. HCM patients are monitored for this and our doctors pay a lot of attention to these pressures if one is increasing in their symptoms. These elevations in pressure could indicate that there has been remodeling that is not particularly positive.

Pam