NYU Langone doctors may prescribe medication to manage the symptoms of hypertrophic cardiomyopathy (HCM). In this condition, the walls of the heart’s lower left chamber, or ventricle, thicken, preventing it from filling with blood. HCM can obstruct blood flow to the body, raising blood pressure in the heart and forcing it to work harder and use more oxygen.
Medication is the first line of treatment for most people with HCM. The right medication regimen can improve symptoms by reducing the obstruction of the left ventricle, and thereby improving its overall performance and its ability to pump blood to the rest of the body.
Commonly prescribed medications for HCM include beta blockers, disopyramide, calcium channel blockers, heart rhythm medications, and anticoagulants.
Beta blockers decrease heart rate, reducing the heart’s workload. They prevent the worsening of obstruction that occurs with exercise, helping to decrease HCM symptoms. These medications work by blocking the hormone adrenaline from increasing the heart rate in response to stress or exercise, also known as the “fight or flight” reaction.
Your doctor may prescribe disopyramide, which stops the heart from beating too forcefully. By relaxing the heart’s contractions, disopyramide reduces the obstruction in the heart, improves symptoms, and can also regulate heartbeat.
Calcium channel blockers work by slowing the absorption of calcium by the heart and blood vessel walls. They slow heart rate and may improve symptoms.
HCM causes atrial fibrillation, or irregular heart rhythm, in 25 percent of patients. This can cause heart palpitations, worsen heart failure symptoms, and can lead to the formation of blood clots that have the potential to travel from the heart to other parts of the body. The most serious clots can cause stroke.
Antiarrhythmic medications help the heart beat normally by blocking irregular electrical activity and rhythms caused by the thickening of the heart’s walls. The most common antiarrhythmics used for people with HCM are amiodarone, sotolol, and disopyramide, which is also used to reduce obstruction.
Your doctor may prescribe anticoagulants, or blood thinners, to help prevent blood clots that result from atrial fibrillation. People who take anticoagulant medications are at reduced risk of stroke, but these medications can lead to excessive bleeding. In most cases, the benefits of preventing stroke outweigh the bleeding risk. Your doctor weighs these factors as you make a decision about anticoagulant therapy.
Maintaining low cholesterol can prevent plaque from building up in the arteries, which can lead to coronary artery disease. However, for many people with HCM, dietary changes are not enough to lower cholesterol to the desired level. In these cases, cholesterol-lowering medications such as statins may be prescribed after detailed discussion.
In addition to patient care, our doctors are also involved in scientific research and in providing education for medical professionals.