admin • October 27, 2022
504 Plans and HCM

We understand how challenging it can be to manage life with HCM, and we want to lend a hand.
As such, this is the first in a series of short articles to help to get you started concerning
issues such as a 504 plan for your child’s school. Other examples are, what qualifies you for
Social Security Disability Insurance benefits, or what you are entitled to as far as the Family
Medical Leave Act (FMLA). As always, if you have any questions, please contact the office at
(973) 983-7429.

Sample 504 Plan for HCM

As a school official, I will assume that you are aware of 504 plans which come from Section 504
of the Rehabilitation Act of 1973. In summary, a 504 plan includes accommodations that
promote student success academically and behaviorally in the classroom. Hypertrophic
Cardiomyopathy (HCM) meets the criteria for a disability under this law, and therefore, the
student is eligible for accommodations. (1)

HCM is the second most common form of heart muscle disease affecting children and
adolescents and is a leading cause of sudden death in young athletes. The cause of HCM
varied in children. However, most cases of HCM in childhood are caused by changes in cardiac
(heart) protein genes. (2)

The diagnosis of HCM in infants is often made during a check for a heart murmur or heart
failure. Older children are usually referred for symptoms, such as abnormal ECGs, and
echocardiograms. Sometimes it may be that a child is found to have HCM after being screened
after a relative was diagnosed. (3)

● Allow the child to have and fill water bottles as needed. A lack of water can
result in serious cardiac issues.
● Ensure automated external defibrillator(s) are available and operational to quickly
get to a child who is having an event. Depending on the size and layout of your
school, multiple units might be necessary.
● Put plans in place to allow someone to start CPR until the defibrillator is
retrieved. Having this plan in place will allow lifesaving efforts to start with no lag
time for getting the defibrillator.
● Consider implementing ‘Hands-only CPR in Schools Training’ and defibrillator
training too if applicable.

● Allow the child to take part in physical education classes, but modify the activity
level, thereby allowing her/him to be active but not stressed or isolated from their
peers.
● Allow more time to take tests, particularly standardized tests as some of their
medication can cause dizziness, weakness, drowsiness, or fatigue. For
example,
● Allow more time for HCM children to get from one classroom to another. The
increased time will depend on how big your school is and how congested the
halls are between classes.

Having our HCM children well hydrated, granting a few needed allowances, and implementing
the appropriate equipment and training, will help ensure we are keeping our children safe.

With these minor revisions and requests, we can save lives- very young lives. Some schools
may already have invested in this equipment and training. Find out if your child’s school is one
of them. By having these devices on-site, students, faculty, maintenance workers, and visitors
will all have a better chance of surviving a cardiac event.

  1. “Fact Sheet: Disability Discrimination.” US Equal Employment Opportunity Commission,
    15 Jan. 1997, https://childrenww.eeoc.gov/laws/guidance/fact-sheet-disability-
    discrimination
  2. JP;, Moak JP;Kaski. “Hypertrophic Cardiomyopathy in Children.” Heart (British Cardiac
    Society), U.S. National Library of Medicine,
    https://pubmed.ncbi.nlm.nih.gov/22591735/#:~:text=Hypertrophic%20cardiomyopathy%2
    0%28HCM%29%20is%20the%20second%20commonest%20form,errors%20of%20met
    abolism%2C%20neuromuscular%20disorders%20and%20malformation%20syndromes
  3. Moak, Jeffrey P, and Juan Pablo Kaski. “Hypertrophic Cardiomyopathy in Children.”
    Heart, BMJ Publishing Group Ltd and British Cardiovascular Society, 15 July 2012,
    https://heart.bmj.com/content/98/14/1044

HCMA Blog

April 30, 2025
Medical Management means using medicines and other non-invasive therapies to relieve symptoms. It's exciting that new treatments for HCM are being studied and that the FDA approved Camzyos in 2022! HCM can cause various symptoms depending on how stiff the heart is, how much scarring (fibrosis) there is, and whether there is obstruction. Some people have no noticeable symptoms. Common symptoms are chest pain/pressure, shortness of breath, lightheadedness, fatigue, palpitations, and brain fog. Syncope (fainting) is dramatic but not as common as the other symptoms. Medications are the first-line treatment for symptoms of HCM. If patients can't take one class of medication, they can try a medication from a different class. Here are some medications used to treat HCM and what they're for: Beta Blockers - make your heart beat slower and relax better. They allow the heart to fill more completely between beats. They can lower blood pressure and relieve symptoms. Calcium Channel Blockers - used to lower blood pressure and slow the heart rate. May reduce symptoms from obstruction in HCM. Myosin Inhibitors - cause the heart to beat with less force. They may reduce obstruction and septal thickness in some patients. Camzyos (mavacamten) is the first of this class of medication. For more information, click HERE . Antiarrhythmics - help to restore normal rhythm in the heart. Blood Thinners - anticoagulants and anti-platelets make it harder for blood to clot. They are prescribed to reduce the risk of stroke. This risk is higher in patients with afib, aflutter, and artificial heart valves. Diuretics , or "water pills," help the kidneys get rid of extra water and salt, reducing swelling in the body. Sodium Channel Blockers - may reduce gradient in obstructive HCM and can treat chest pain. Some also act as antiarrhythmics. Antibiotics - treat or prevent bacterial infections. In HCM, they may be given before dental work to prevent infective endocarditis. To learn more and see the side effects of these medications, click HERE .
On a green background, a line drawing of a head that has complicated arrows pointing outwards
By Gordon Fox April 25, 2025
Part 2 of a series on making decisions in HCM. A key reason is that decision making is so difficult is that most decisions involve more than one risk.
Hypertrophic Obsctructive Cardiomyopathy
By Erica Friedman April 22, 2025
Bristol Myers Squibb announces that Camzyos has been approved for Obstructive Hypertrophic Cardiomyopathy in Japan.
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