The diagnosis is based on the patient's symptoms (if any), a complete physical examination, and tests that detect abnormalities of the heart chambers. Usually, there is an abnormal heart murmur that worsens with the Valsalva maneuver. The electrocardiogram (ECG), which provides a record of electrical changes in the heart muscle during the heartbeat, also is typically abnormal.
Sometimes, a routine chest x ray may show that the heart is enlarged. Echocardiography, a procedure that produces images of the heart's structure, is usually done. These images can show if the heart wall is thickened and if there are any abnormalities of the heart valves.
Patients with hypertrophic cardiomyopathy are also told to avoid strenuous exercise to reduce the risk of passing out or sudden death.
In some cases, if the medications do not help relieve symptoms, surgery may help. In an operation called myotomy-myectomy a piece of the septum is removed to improve blood flow through the heart chamber.
Some patients have pacemakers and/or defibrillators implanted to help control the heart rate and rhythm. Pacemakers and defibrillators provide electrical impulses to the heart, which can return the heart beat to a normal rhythm.
If these treatment methods fail and a patient develops heart failure, a heart transplant may be necessary.
Toni Rizzo, The Gale Group Inc., Gale, Detroit,