In The News

Dr. Keith Mankowitz, St. Luke's Hospital

Women with hypertrophic cardiomyopathy often underdiagnosed

You've likely seen it - a news story that flashes on screen about an active individual or athlete who suddenly falls to the ground with their life cut short. Being active or involved in sports ourselves, we often fail to realize that we're all at risk for this condition called hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy is very common and can affect people at any age. About one out of every 500 people has hypertrophic cardiomyopathy, and it affects men and women equally.

However, a study in the Journal of the American College of Cardiology shows this condition is oftentimes overlooked in women. Research has indicated that for women, hypertrophic cardiomyopathy is regularly underrepresented based on underdiagnosis, low patient awareness and availability of screening programs. Because of these factors, many women with hypertrophic cardiomyopathy showed a higher risk of advanced heart failure or death.

Hypertrophic cardiomyopathy is the leading cause of heart-related sudden death in people under the age of 35. In short, hypertrophic cardiomyopathy is a condition where the myocardium (heart muscle) becomes enlarged, which makes it difficult for the heart to pump blood efficiently. As a result, hypertrophic cardiomyopathy can interfere with the heart's electrical system, causing those with the condition to suddenly experience several life-threatening symptoms including chest pain, dizziness, fainting, fatigue, heart murmurs and arrhythmias, irregular heart rhythms, palpitations and shortness of breath.

Hypertrophic cardiomyopathy can be genetic, so anyone with a relative who has been diagnosed or treated for hypertrophic cardiomyopathy should seek medical advice and get screened. In other instances, there is no genetic relationship. Because of this, all adults who are physically active or play sports should be screened.

Typically, following a thorough examination of the patient's history and a physical examination, tests are given to determine if someone is at risk for hypertrophic cardiomyopathy. They include a limited view echocardiogram (an ultrasound of the heart) that focuses on assessing the thickness and function of the heart and an electrocardiogram, which tests electrical activity of the heart.

Treatment is given on an individualized basis. Various options, depending on the severity of the condition, include monitoring, medications (beta-blockers) and specialized surgery which resects or removes the muscle tissue that may be obstructing the heart function.

Dr. Keith Mankowitz is a cardiologist at St. Luke's Hospital and treats those with hypertrophic cardiomyopathy across the St. Louis region. For more information or to get screened, call 314-434-3278.

This article was published in the St. Louis Post-Dispatch on January 22, 2015.