What is HCM?
HCM stands for hypertrophic cardiomyopathy. HCM is a thickening of the heart muscle that disrupts the main pumping chamber of the heart. Most cases of HCM are congenital, which means that the person is born with the condition.

What are the symptoms of HCM?
There is no particular symptom or complaint which is unique to hypertrophic cardiomyopathy. Symptoms may occur at any stage in a person’s life even though the condition may have been present for some time. The reason for the onset of symptoms is often not clear, but in many cases first occurs during or immediately after exertion or exercise.

It should also be mentioned that some symptoms of HCM may be under-appreciated even by the patient. Due to the fact that HCM can be present in many people for years prior to identification, they may have grown accustom to feelings that an otherwise “healthy” person would notice immediately.

These are the classic symptoms of HCM:

  1. Shortness of Breath: Exercise capacity may be limited by breathlessness and fatigue. Most individuals experience only mild exercise limitations, but occasionally limitation is severe, and some may have shortness of breath at rest.
  2. Chest Pain: Chest pain is a common symptom. It is usually brought on by exertion and relieved by rest, but pain may occur at rest or during sleep and may persist. The cause of the pain is thought to be insufficient oxygen supply to the myocardium (the heart musculature). In hypertrophic cardiomyopathy the coronary arteries are usually normal, but the greatly thickened muscle demands an increased oxygen supply which cannot be met in some circumstances.
  3. Palpitation: Palpitation is an uncomfortable awareness of the heartbeat. People may occasionally feel an extra beat or a skipped beat and this is usually normal. Sometimes an awareness of the heart beating does suggest an irregular heart rhythm. In this case, palpitations may start suddenly, appear to be very fast and may be associated with sweating or light-headedness. The cause of such episodes should be determined and treated if necessary.
  4. Light-Headedness and Blackouts or Fainting: Persons with the condition may experience light-headedness, dizziness and, more seriously, blackouts or fainting. Episodes may occur in association with exercise, with palpitations or without any apparent provocation. The reason for these episodes is not always clear. They may be due to an irregularity of the heartbeat or fall in blood pressure. Episodes of light-headedness and certainly any loss of consciousness should be reported to one’s doctor immediately.

Most commonly seen “misdiagnosis” associated with HCM?
Most commonly seen is asthma, specifically ‘athletically induced asthma” as a first sign or symptom. This is likely due to transient shortness of breath often seen in HCM. It is also common to have a diagnosis of mitral valve prolapse prior to the proper diagnosis of HCM. This often happens when an audible murmur is heard and thought to represent mitral valve prolapse, an unrelated and relatively mild condition. It is not uncommon to see people having been diagnosed with anxiety attacks, panic attacks or some forms of depression, only to find that the underlying cause of the symptoms is HCM.

Above information provided by the HCMA (Hypertrophic Cardiomyopathy Association). Edited by Bruce Martin, M.D.

How long will the screening last?
The screening process, including blood pressure measurement as well as an ECG and ECHO, takes around 15 minutes.

Will I need to accompany my student to the screening?
Yes, we recommend coming with your student to the office. Since the student is a minor, it’s better for him or her to be accompanied by a guardian for convenience and emotional support.

Why is it best to have my child screened during their teen years? 
Risk of developing HCM increases with age, and the possibility of having a cardiac event because of HCM increases with physical activity. Ages 14-20 are screened because the heart is closer to maturity and competitive sports participation and/or physical activity may be increased during high school and college.

What is an echocardiogram (ECHO)?
The echocardiogram (ultrasound of the heart) is an extremely useful test for studying the heart’s anatomy.   It is non-invasive and entirely safe. Your child will lie on an exam table and a female sonographer (echo technician) will move a transducer (a device that looks like a computer mouse) against your child’s chest. This results in an electronic image that allows the doctor to detect the presence of HCM.

Who should get tested?
Any child involved in a high exertion activity such as: sports, cheerleading or marching band.

Why is it best to have my child screened during his or her teen years?  
The risk of dying from HCM peaks in the teen years, and that’s generally when young people begin to participate in highly competitive sports and exertional activities.  And, in general, once a person has “made it” into his later 20′s and 30′s, by definition he’s at lower risk because he has gotten past the peak risk time.

Should college-age athletes also be screened?
Yes. These young athletes also fall into the “at risk” age group.