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What is hypertrophic cardiomyopathy in children? — Hypertrophic cardiomyopathy in children is a condition that makes the heart muscle get too bulky (figure 1). When this happens, it can keep the heart from pumping blood as well as it should. This can cause breathing problems, chest pain, and other symptoms.
Hypertrophic cardiomyopathy is usually caused by an abnormal gene that runs in families.
What are the symptoms of hypertrophic cardiomyopathy in children? — Some children show no symptoms, while others do.
People with hypertrophic cardiomyopathy sometimes have a heart murmur. This is an extra sound that doctors or nurses hear when they listen to the heart with a stethoscope. A doctor or nurse might find a murmur during a routine exam, such as before a child starts playing sports.
Babies (under a year old) might also have symptoms, such as being much more tired than usual, breathing fast, or having trouble feeding.
Most children over the age of 1 year have no symptoms. When symptoms do happen, they can start in childhood or the teenage years. Symptoms are most common around puberty. Puberty is a term for the changes in the body that happen during the preteen and teen years. The symptoms of hypertrophic cardiomyopathy can include:
●Breathing problems, especially during exercise
●Chest pain that is often worse during exercise
●Fainting or feeling about to faint
●Heart palpitations, which feel like the heart is pounding, beating hard or fast, or skipping beats
Is there a test for hypertrophic cardiomyopathy? — Yes. If a doctor thinks your child might have hypertrophic cardiomyopathy, they can order tests. These can include:
●An "electrocardiogram" (also called an "ECG") – This test measures electrical activity in the heart. It involves sticking patches called "electrodes" onto the chest, arms, and legs (figure 2). The patches have wires that connect to a special machine that measures the electrical activity in the heart.
An ECG can show if the heart is beating in a normal pattern and rhythm. An ECG can also show thickening of the heart muscle. The doctor might have your child exercise during the test.
●An "echocardiogram" (also called an "echo") – This test uses sound waves to create an image of the heart (figure 3). Doctors use it to see how thick the walls of the heart are, measure the spaces inside the heart, and see how well the heart pumps blood. The doctor might have your child exercise during the test or right beforehand.
●Genetic testing – This can show if your child has the abnormal gene that some people with hypertrophic cardiomyopathy have.
Depending on your child's situation, they might need other tests, such as:
●Cardiac catheterization (also called "cardiac cath") – During this test, the doctor puts a thin tube into a blood vessel in your child's leg or arm. Then they move the tube up to the heart. The doctor can also put a dye that shows up on an X-ray into the tube. Cardiac cath can help measure pressure inside the heart and find problems caused by hypertrophic cardiomyopathy.
●Cardiac MRI – This test creates images of the heart. It can show parts of the heart that are hard to see with an echocardiogram and give doctors other information about the heart.
If your child is found to have hypertrophic cardiomyopathy, their siblings should get tested for it, too. Tests include a physical exam as well as an electrocardiogram (ECG) and echocardiogram. Siblings usually need tests every year between the ages of 12 and 18. After the age of 18, most people only need to be tested once every 5 years. If your child has an abnormal gene, any brothers or sisters should get genetic testing to look for this, too.
Should my child see a doctor or nurse? — Call the doctor or nurse right away if your child has hypertrophic cardiomyopathy and has any of the symptoms listed above. Symptoms can include trouble breathing, chest pain, fainting, or heart palpitations. Babies might have trouble feeding or gaining weight.
The doctor can do tests and decide whether your child needs treatment.
How is hypertrophic cardiomyopathy in children treated? — If your child does not have symptoms, they probably will not need treatment. If symptoms happen, treatments include:
●Medicines to help with chest pain or breathing problems
●Medicines to control the heart's rhythm
●A device called a "defibrillator" – This can sense and control abnormal heartbeats. It is placed under the skin near the heart (figure 4).
●Surgery – Doctors can do surgery to remove parts of the heart muscle. But this is done only when medicines do not work.
Can I do anything to help my child? — Yes. It is important to ask your child's doctor what types of physical activity are safe for your child. Children with hypertrophic cardiomyopathy can have problems that make exercise dangerous or even life-threatening. Your child might need to avoid certain sports or activities. It's also important to make sure your child gets all their vaccines.
You can also make sure your child always drinks enough water. People with hypertrophic cardiomyopathy sometimes have problems, such as fainting, when they do not get enough fluids. On the other hand, some people with hypertrophic cardiomyopathy need to be careful if they have too much salt and water. Ask your doctor what is safe for your child.
What will my child's life be like? — Your child will probably need regular exams and tests, medicines, or other treatments. They might also need to avoid certain activities.
A few people with hypertrophic cardiomyopathy get serious heart problems. But most people are able to live normal lives.
Patient education: ECG and stress test (The Basics)
Patient education: Echocardiogram (The Basics)
Patient education: Hypertrophic cardiomyopathy in adults (The Basics)
Patient education: Syncope (fainting) (The Basics)
Patient education: Implantable cardioverter-defibrillators (The Basics)
Patient education: Hypertrophic cardiomyopathy (Beyond the Basics)
Patient education: Implantable cardioverter-defibrillators (Beyond the Basics)
