Hypertrophic Cardiomyopathy: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Hypertrophic Cardiomyopathy?
A cardiologist, a doctor who treats heart disease, usually diagnoses and treats hypertrophic cardiomyopathy. Close family members of a person with HCM may be screened for the condition. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is hypertrophic cardiomyopathy?
Hypertrophic cardiomyopathy (HCM) is a condition in which the heart muscle becomes thick.
The thickening can make it harder for blood to leave the heart. The heart then has to work harder to pump blood. The thickening can also make it harder for the heart to relax and fill with blood.
Symptoms
Some people have no symptoms. They may first learn about the problem during a routine medical exam. Others may have:
- Chest pain.
- Dizziness, or lightheadedness especially with or after activity.
- Fainting, especially during exercise.
- Tiredness.
- A feeling that the heart is beating fast or unevenly (palpitations).
- Shortness of breath with activity or after lying down.
Passing out or collapsing is an emergency. See When to see a doctor. In many young adults, the first symptom is sudden collapse. It can be caused by very abnormal heart rhythms, called arrhythmias. It can also be caused by a blockage that stops blood from leaving the heart.
People with HCM are at higher risk for sudden death than people without it. This can happen at a young age. HCM is a well-known cause of sudden death in athletes.
Causes and who gets it
HCM is most often passed down through families. It is thought to result from changes, called variants, in the genes that control heart muscle growth.
Younger people are likely to have a more severe form. However, HCM is seen in people of all ages. Close family members of a person with HCM may be screened, most often with an echocardiogram or genetic testing.
How doctors diagnose it
Your provider will do a physical exam and listen to your heart and lungs with a stethoscope. They may hear a heart murmur, which is an abnormal heart sound. Tests may include:
- An electrocardiogram (ECG), which records the heart's electrical activity.
- An echocardiogram, which uses sound waves to make moving pictures of your heart.
- A heart rhythm monitor worn for 24 hours or longer.
- An exercise stress test.
- A heart MRI, which uses radio waves and magnets to make detailed pictures.
Blood tests may be done to check for other diseases. Genetic testing can find inherited types of cardiomyopathy.
Treatment
Always follow your provider's advice about exercise. You may be told to avoid strenuous exercise. See your provider for regular checkups.
If you have symptoms, you may need medicines such as beta-blockers or calcium channel blockers. Other newer medicines help the heart contract and relax correctly. These may ease chest pain or shortness of breath when you exercise.
For obstructive HCM, your provider may prescribe mavacamten, which relaxes the heart muscle. It may raise the risk of heart failure. So it is only for people whose ejection fraction is at least 55%. Ejection fraction is the percentage of blood your heart pumps out with every heartbeat.
People with arrhythmias may need medicines for the abnormal rhythm. Those with atrial fibrillation may need blood thinners to lower the risk of blood clots. Some need a pacemaker to control the heartbeat. Some need an implanted defibrillator, which senses life-threatening heart rhythms and sends an electrical pulse to stop them. It may be placed even without a past arrhythmia if the risk is high.
When blood flow out of the heart is severely blocked, a surgeon may remove part of the thickened septum, the wall inside the heart. This is called surgical myectomy. Some people instead get an alcohol injection into the arteries that feed the thickened part. This is called alcohol septal ablation. People who have it often show much improvement. Surgery to repair a leaking mitral valve may also be needed.
When to see a doctor
Contact your provider if you have any symptoms of HCM, or if you develop palpitations or other new or unexplained symptoms. Ask about exercise before you start new activities.
Call 911 or go to the emergency room if you collapse or lose consciousness, have chest pain lasting two minutes or more, or have severe trouble breathing.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can help you keep up with checkups and track your symptoms. They can also coordinate visits with a cardiologist and help relatives ask about screening.
Common questions
Is hypertrophic cardiomyopathy inherited?
Yes, it is most often passed down through families. It is thought to result from variants in the genes that control heart muscle growth. Close family members may be screened with an echocardiogram or genetic testing.
Can people with hypertrophic cardiomyopathy live a normal life?
Some can. Some people have no symptoms and a normal lifespan. Others get worse slowly or quickly, so regular checkups with your provider matter.
Does hypertrophic cardiomyopathy cause sudden death?
It can. People with HCM are at higher risk for sudden death than people without it, and this can happen at a young age. Almost half of deaths from this condition happen during or just after some type of physical activity.
Do I need to avoid exercise with hypertrophic cardiomyopathy?
It depends, so follow your provider's advice about exercise. You may be told to avoid strenuous exercise.
Sources
- MedlinePlus - Hypertrophic cardiomyopathy
- National Heart, Lung, and Blood Institute - Cardiomyopathy Diagnosis
- National Heart, Lung, and Blood Institute - Cardiomyopathy Treatment
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
