Overview 
Hypertrophic cardiomyopathy (HCM) is a condition when the heart muscle is abnormally thick. In majority of cases misspelling of one or more genes can be detected. The transmission of the abnormal gene is autosomal i.e. the offspring of the affected individual would have one in two chance of inheriting the condition.

Symptoms
Patients with HCM generally have no symptoms and are able to lead normal lives. However, in some, chest pain and breathlessness on exertion can be the first presenting complaints. Giddiness or near fainting episodes may be seen sometimes and fast irregular heart rhythm usually occurs in older patients. Rarely, sudden cardiac death is the first and last clinical presentation.

Treatment
As HCM is a genetic condition, the goal of treatment is not to cure but to relieve symptoms and prevent sudden cardiac death for those at high risk.

Majority of patients with no symptoms would not require treatment. In patients suffering from chest pain or breathlessness, medication like beta blocks or calcium channel blockers are usually prescribed. In instances when symptoms are not well controlled with maximal medication, intervention to reduce thickness of a portion of the thickened heart muscle can be carried out. Alcohol septal ablation reduces the muscle thickness by creating a ‘controlled’ heart attack whereas myectomy is an open heart surgery. 

Patients who have family history of sudden cardiac death; unexplained fainting spell; severe thickening of heart muscle or dangerous heart rhythm, are considered to be at high risk of sudden cardiac death. An Implantable Cardioverter Defibrillator can be life-saving in this group of patients.