Hypertrophic obstructive cardiomyopathy (HOCM)

[atydev]

I recently found out I have HOCM on top of all my other heart problems. I do know this is heriditary. My question is has anyone else had this condition and did the surgeons go in and remove that portion of the heart that got thick, and if so do I have to worry about it returning or is this something that when they go in and remove that portion of the heart is it gone forever. What can I expect for the future with this condition.

 

[Ross]

http://www.clevelandclinic.org/heartcenter/pub/professionals/cardiacconsult/2002/summer/hocm.htm

It doesn't really answer your questions, but may be worth the read to you.

 

[BillCobit]

HOCM Tx

HOCM Tx

April -

Following link reiterates treatment description in Ross's link, plus some general overview info about HOCM (if it's helpful to you). Unfortunately, no info on re-growth / re-op.


http://www.heartcenteronline.com/myheartdr/common/artprn_rev.cfm?filename=&ARTID=430

"If medication is not successful, a permanent pacemaker may be considered. A pacemaker controls the heartbeat by pacing the heart at a slightly faster rate than the patient's natural heartbeat. This treatment may be successful in reducing the major symptoms, chest pain and shortness of breath, in about 50 percent of patients. It is typically used in patients with hypertrophic obstructive cardiomyopathy (HOCM). By creating an abnormal pattern of electrical activity in the ventricle, the extent of the obstruction by the thickened muscle can be reduced.


In about five percent of cases, the blockage created by the heart?s enlargement must be reduced by surgical means. One procedure used is a septal myomectomy. This surgery involves the removal of part of the thickened septum (the muscular wall between the left and right ventricles). About 75 percent of patients show some long-term improvement after this procedure. In some cases, the mitral valve may need to be replaced. A mitral valve replacement may accomplish the following:

1) Improved blood flow out of the ventricles, because it removes the portion of the mitral valve that had been moving into the area of the septum and obstructing blood flow out of the ventricles.


2) Reduction of a severe leakage, called mitral regurgitation, which can contribute to symptoms of heart failure in this situation.

A relatively new procedure called alcohol ablation is also available for people with hypertrophic obstructive cardiomyopathy. This minimally invasive treatment, which may be administered during cardiac catheterization, involves the destruction of certain heart cells with ethanol (alcohol) to shrink the heart muscle and increase the space for blood to flow. The ethanol can be placed in a specific branch of one of the heart's arteries that provides blood to the septum. Early results have been promising, showing long-term benefit as well as shorter recovery periods compared to traditional surgery. One common complication, however, has been the development of heart block, requiring implantation of a pacemaker. But, researchers are already seeing a decrease in the rate of complications as the technique has evolved, and envision alcohol ablation as a standard therapy in some types of hypertrophic cardiomyopathy.

Because a hypertrophic cardiomyopathy can cause potentially fatal arrhythmias, an electrophysiology study may be performed to determine whether an internally implantable cardioverter defibrillator (ICD) is necessary. In an electrophysiology study, the physician uses a catheter technique to feed a thin tube (catheter) through a blood vessel (vein) in the body to the right ventricle of the heart. There, the physician tries to create a very fast heart rhythm (ventricular tachycardia) by introducing premature electrical impulses. If no ventricular tachycardia is created, then the patient is judged to be at lower risk of experiencing this condition in the future. On the other hand, if the ventricular tachycardia was elicited, then an ICD may be necessary.

 

[Susan BAV]

April -

My dad had that . He was "in the works" to go in for the alcohol ablation when he was diagnosed with late-stage adenocarcinoma. Esophageal cancer. He died at age 66, from the cancer. His doctors were always concerned that I might develop the hypertrophic cardiomyopathy. The initials for the disease used to be IHSS, I think. My dad wasn't diagnosed with it until he was probably in his late 40's or early 50's. Prior to that, he had been told by a cardiologist that he had a very athletic heart. I believe that he had gone in for the cardio check up because he had begun passing out. The athletic heart diagnosis was odd to us, his family, because he wasn't very active. I understand now that it is a classic early warning sign. He began passing out more frequently. At some point he was put on Verapamil. He always told me that he felt like Verapamil "saved" his life because it helped him with the disease, although he still had episodes of passing out. He was eventually put on extremely high doses of Verapamil. He took that medication for fourteen years. I'm not sure what else he was prescribed for it. Verapamil can cause acid reflux, which can lead to Barrett's Esophagus, leading to adenocarcinoma... He was a big man and he used to drop like a ton of bricks when he would pass out. He eventually had enough experience with it that he knew when it was going to happen and he would try to avoid reaching the trigger point. A year before the cancer diagnosis, he "died" on the treadmill, when his cardiologist wanted to see him push past the trigger point. It took several shocks with the paddles to get him going again. Then they gave him a pacemaker but he was in V-tach very often. He couldn't walk much faster than anyone else could crawl. And he was struggling with congestive heart failure by then. He was hoping to have the ablation at a place in Baylor, Texas that had developed a technique with 0% mortality for the procedure. (I may not be using the correct terminology and I also apologize for my misspellings.)

 

[Susan BAV]

Oh, and April, I did read or hear several years ago that the thickness can grow back, if cut out. I don't recall where I read or heard that though.

 

[atydev]

Thanks

Thanks

I was told in April I had this condition after all the years of heart problems it was just now found. I found that to be a little strange but anyway I was not givin any options nor told anything other than this was a thickening of the heart and would be cut out during my valve replacement which is about a week and a half away. I will be asking all these questions to my surgeon but would love to know anyone's experience with this condition. Thanks for all the info.