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Stanford Health Care

Hypertrophic Cardiomyopathy

How We Can Help You

Hypertrophic cardiomyopathy (HCM) occurs when the heart muscle thickens over time. This thickening usually occurs in the left ventricle, the chamber of the heart responsible for pumping oxygen-rich blood to the body. HCM may affect the heart in various ways. In some people, this thickening or related mitral valve abnormalities, block the flow of blood from the heart, leading to symptoms. In others, the thickened muscle limits the ability of the heart to pump a normal ammount of blood, by restricting the size of its chamber or its ability to relax. HCM also increases the chance that a person will have irregular heart rhythms (arrhythmias), which can be life-threatening.

With the right care, most people can have a full life and avoid the life-threatening complications that can arise when hypertrophic cardiomyopathy is not properly identified and managed.

Our world-renowned hypertrophic cardiomyopathy center of excellence contributes to the latest clinical research on HCM. Our doctors have pioneered many HCM treatments and continue to improve care by testing new therapies and exploring genetic causes of this cardiomyopathy. We specialize in expert interpretation of genetic testing, which can provide crucial treatment guidance and protect your family.

FEATURED

Hypertrophic Cardiomyopathy (HCM) Comprehensive Treatment & Care
Stanford: Genetic Testing and Advanced Care for Families With Heart Disease

What We Offer You For Hypertrophic Cardiomyopathy

  • Internationally recognized expertise from specialists who write national care guidelines, publish leading research, and see a high volume of patients each year.
  • Advanced diagnostic tools and expertise to recognize the often subtle clues that establish a diagnosis of hypertrophic cardiomyopathy and distinguish it from other similar conditions, including athlete’s heart.
  • Team-based planning featuring HCM-focused cardiologists working with specially trained cardiovascular nurses and genetic counselors for comprehensive medical and genetics care.
  • Evidence-based treatments including specialized procedures and surgeries that are not widely available and a new scientific approach to creating safe and flexible exercise plans.
  • Genetic counseling to help you assess and manage your family’s risk of HCM, including a partnership with Stanford Children’s Health for specialized pediatric services.
  • Comprehensive support to help with diet, exercise, medications, family planning, and the emotional challenges of diagnosis and treatment.

Treatment for Hypertrophic Cardiomyopathy

Our team of cardiologists, electrophysiologists, genetic counselors, advanced practice providers, nurses, and other specialists work together to thoroughly evaluate your heart and your medical and family histories. We use the latest diagnostic technology, including a specialized echocardiogram that involves you exercising on a treadmill or stationary bicycle. This test allows us to assess your left ventricular blood flow, heart thickness and stiffness, valve functioning, electrocardiogram (ECG) changes, and exercise capacity. We also work with Stanford Sports Cardiology to check athletes for cardiovascular irregularities.

We tailor your treatment recommendations to your heart’s specific needs. Some people may need only lifestyle adjustments and annual clinic visits with heart testing. Other people may require medications or additional interventions to manage their condition. Depending on your personal situation, your care plan may include a single treatment approach or a combination of these options:

Genetic Testing & Counseling

Our genetic counselors have special training in the genetics of hypertrophic cardiomyopathy, as well as the best ways to help you assess your family’s risk. Test results can guide treatment, identify affected family members, and help with family planning. Learn more about our counseling services

Medication & lifestyle changes

We work with you to find the right oral medications at the right doses to address your specific symptoms. We often also offer clinical trials for newer medications.

Our center leads the world in exploring the safety of exercise for people with HCM. We develop an exercise prescription specifically for you using the information we gather from your heart testing. Your personalized exercise prescription provides you with specific information about exercise intensity and target heart rates. Our goal is to help you live the active life you want while safely managing HCM risks and symptoms.

Cardiac behavioral therapy 

We understand that living with a chronic heart condition can present challenges. Our team includes psychologists who are specially trained in the needs of cardiovascular patients. These experts provide behavioral therapy and other services to promote your resilience and help you adjust to your diagnosis. They also support you in making important lifestyle adjustments.

Arrhythmia treatment

People with hypertrophic cardiomyopathy are at higher risk for developing an irregular heart rhythm known as an arrhythmia. These life-threatening arrhythmias can include atrial fibrillation, which can increase your risk of stroke, and ventricular tachycardia. People do not always feel these irregular heart rhythms, so we perform regular rhythm monitoring. We offer expert care to protect your heart from arrhythmias.

  • Devices: To keep your heartbeat in the normal range, your doctor may recommend an implantable cardioverter-defibrillator (ICD), a device that should not be confused with a pacemaker. ICDs provide continuous monitoring to detect dangerous arrhythmias, delivering a lifesaving shock as needed to restore a normal heart rhythm. We offer both traditional endovascular ICDs and subcutaneous ICDs.

Treatment options for people with obstructive HCM

Some people have a type of hypertrophic cardiomyopathy called obstructive HCM that interferes with the smooth flow of blood leaving the heart.

  • Procedures: Your team may refer you to a specially trained Stanford cardiovascular interventionist to discuss alcohol septal ablation, a type of cardiac ablation. During these ablations, a small incision is made in the groin, and alcohol is injected into a coronary artery through small catheters. The alcohol shrinks the thickened heart muscle, potentially improving blood flow by removing or reducing the blockage. Stanford doctors were among the first to use this minimally invasive procedure.
  • Cardiothoracic surgery: Stanford is a West Coast leader in myotomy, also called myectomy. This open-heart surgery may provide the best treatment choice for obstructive hypertrophic cardiomyopathy and is performed by a specially trained HCM surgeon. During the surgery, the thickened heart muscle is shaved away to improve blood flow. Depending on your situation, a valve repair, valve replacement, or other cardiac procedures may be done during the same procedure.

Advanced heart treatments

In rare cases, advanced hypertrophic cardiomyopathy may lead to heart failure and require more significant intervention, such as a left ventricular assist device (LVAD) or heart transplant. Stanford surgeons are internationally recognized for their expertise in these treatments, many of which were pioneered here at Stanford.


Part of the Care Community

We maintain close ties with the Hypertrophic Cardiomyopathy Association, a leading HCM patient advocacy group, and  and are an HCMA Center of Excellence. We have also been longtime collaborators with the Sarcomeric Human Cardiomyopathy Registry (SHaRe), which aims to expand clinical knowledge of HCM and provides educational events for HCM patients.

Clinical Trials

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Open Clinical Trials

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Clinical trials for hypertrophic cardiomyopathy often test new medications. These studies may provide eligible participants with a chance to try the latest treatments and to help others who live with HCM.

Open trials refer to studies that are currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future. To learn more about the clinical trials we offer, contact [name and number].

Closed trials are not currently enrolling but may open in the future.

What Is Hypertrophic Cardiomyopathy?

Overview

Hypertrophic cardiomyopathy is the most common genetic cardiomyopathy, thought to affect at least 1 in 500 people. It usually affects the left ventricle, the chamber of the heart responsible for pumping oxygenated blood to the body. HCM causes heart muscle to thicken and heart muscle cells to become disorganized. The thickening can make the left ventricle stiffer, causing it to have problems relaxing and filling properly, a complication called diastolic dysfunction, that can lead to diastolic heart failure. HCM can also lead to problems with the mitral valve, enlargement of the left atrium, and life-threatening irregular heart rhythms such as ventricular tachycardia and atrial fibrillation.

In general, there are two major forms of HCM: non-obstructive and obstructive. In non-obstructive HCM, the left ventricular muscle is thick, but blood can easily move from the left ventricle out to the rest of the body. In obstructive HCM, blood cannot flow smoothly from the heart to the body due to a blockage caused by the thickened heart muscle and may also involve the mitral valve. In both forms of HCM, the heart muscle squeezes more forcefully than normal, and the thickening of the heart leaves the left ventricular chamber smaller, meaning the heart has difficulty pumping blood efficiently. In severe but less common cases, the thickened heart can become larger and its walls thinner over time — more like another form of cardiomyopathy called dilated cardiomyopathy.

Arrhythmias caused by hypertrophic cardiomyopathy can cause sudden death and are sometimes the first sign of HCM. A family history of early unexplained sudden death, unexplained fainting, unexplained accidents, early heart failure, or early arrhythmia may suggest HCM or another inherited cardiac disease. If you have a diagnosis of HCM or have signs of a heart condition in your family history, you can meet with a genetic counselor to talk about whether genetic testing is right for you.

Although there can be serious complications, many people with HCM live normal lives with minimal treatment. Among those who need treatment, many live healthy, long lives, while attending school, enjoying careers, and having children. We can help you and your family, whether you come to us with known cardiomyopathy in your family or because you are having symptoms yourself.

Our Clinics

Hypertrophic Cardiomyopathy Center
We specialize in the care of patients with hypertrophic cardiomyopathy (HCM) and other forms of familial cardiomyopathy.
Hypertrophic Cardiomyopathy Center
300 Pasteur Drive
2nd Floor, Room A260
 Stanford, CA 94305
Phone: 650-736-7878 Getting Here
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Phone: 650-736-7878
300 Pasteur Drive
2nd Floor, Room A260
 Stanford, CA 94305
Phone: 650-736-7878
5565 W. Las Positas Blvd.
 Suite 150
 Pleasanton, CA 94588
Phone: 925-278-7017
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To schedule an appointment, please call: 650-721-4363