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Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a heart condition that tends to run in families. It causes the heart muscle to become too thick, making it harder for your heart to pump blood. This increases your risk of certain complications, including:

You can prevent or treat these problems by seeking care from HCM specialists — like those at VCU Health. We offer advanced testing that can diagnose HCM early, before you develop complications. And we’ll help you manage any symptoms that occur so you feel (and stay) healthy.

Hypertrophic Cardiomyopathy Symptoms

In many cases, HCM doesn’t cause any symptoms. However, if your condition is severe or causes complications, you may develop one or more of the following:

  • Chest pain or discomfort, especially during exercise
  • Dizziness or lightheadedness
  • Fainting during (or right after) exercise
  • Racing, pounding or fluttering heartbeat
  • Shortness of breath

See your doctor right away if you have any of these symptoms. It’s important to find out whether you have HCM or another cardiovascular condition. That’s because HCM can cause sudden cardiac death in people of all ages — even those who are young, active and otherwise healthy.

Hypertrophic Cardiomyopathy Diagnosis

We combine cardiac imaging and genetic testing to see if you have HCM — and determine how it’s likely to affect you.

Cardiac imaging tests

Depending on your symptoms, you may have one or more of the following imaging procedures:

  • Cardiac MRI scan – A test that uses magnetic fields instead of radiation to take detailed pictures of your heart.
  • Echocardiogram – Uses sound waves to create pictures of your heart.
  • Electrocardiogram (EKG)  – Records the heart’s electrical signals to see if your heart beats normally.
  • Exercise stress test – A type of EKG that shows how well your heart works while you walk or run on a treadmill.
  • Holter/event monitor: Wearable devices that help detect rhythm disorders associated with hypertrophic cardiomyopathy.

Genetic testing for hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is usually caused by an abnormal gene (genetic mutation). It’s one of the most common types of familial (inherited) heart disease.

Genetic testing using blood or saliva samples may confirm whether you have one of these abnormal genes. Together with your cardiac imaging scans, your genetic test results provide important information about your condition and your level of risk.

Not only does this information help us tailor your treatments, but it can also help you live with less worry. For example, we can prescribe medicine to control the symptoms your specific gene mutation is most likely to cause. And we can confirm which exercises, sports or other activities you can safely take part in.

If you have a parent with HCM, you (and your siblings) have a 50% chance of inheriting the genetic mutation responsible. And if you have HCM, your children have a 50% chance of inheriting the abnormal gene.

To that end, we can also test your parents, siblings or children for the gene mutation — even if they don’t live in Virginia.

Hypertrophic Cardiomyopathy Treatment

The treatments you’ll need for HCM depend on the severity of your symptoms and whether you’ve developed any complications that also need treatment. We offer:

  • Medicine. Certain prescription drugs can slow your heart rate, improve blood flow, prevent blood clots or help your heart pump better.
  • Septal artery alcohol ablation. Injections of alcohol help thin out some of the thickened heart muscle (septum) that separates the top two chambers of your heart.
  • Implantable devices. If medicine doesn’t improve your symptoms, you may also need a pacemaker or implantable cardioverter defibrillator (ICD). Pacemakers speed up a heart rate that’s too slow, while ICDs slow down a heart rate that’s too fast. Implantable cardioverter defibrillators can also help prevent sudden cardiac arrest.
  • Ablation for arrhythmias (afib and VT)
  • Septal myectomy. Surgery to remove part of the thickened septum.

We can also help you make lifestyle changes — such as losing weight, quitting smoking or improving your diet — that will help keep your heart as healthy as possible.

A Team Approach to HCM Treatment

When you choose us, you have access to a team of experts that has years of experience treating HCM and its complications. In addition to your cardiologist expert, Dr. Mohammed Makkiya, and genetic counselor, you may work with providers who specialize in:

Our team also includes pediatric cardiologists who treat HCM in children and teens.

Contact Us

For patients

To schedule an appointment with our HCM specialist, Dr. Mohammed Makkiya, please call (804) 628-4327, weekdays from 8 a.m. to 5 p.m., or request an appointment online.

For physicians

To schedule an appointment with a hypertrophic cardiomyopathy specialist at Pauley Heart Center, please call (804) 628-4327 weekdays from 8 a.m. to 5 p.m., or request an appointment online. Providers can also call this number to refer their patient for further evaluation or potential treatment.


To learn more, visit the Hypertrophic Cardiomyopathy Association website.

To learn more about ICD therapy, visit the Colorado Program for Patient Centered Decisions website.

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