Title: Hypertrophic cardiomyopathy in children

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? — Most children have no symptoms. A doctor or nurse might find hypertrophic cardiomyopathy during a routine exam, such as before a child starts playing sports.

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 pre-teen 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
Should my child see a doctor or nurse? — If your child has symptoms of hypertrophic cardiomyopathy, especially during exercise, call your doctor or nurse right away.

Is there a test for hypertrophic cardiomyopathy? — Yes. If the doctor or nurse thinks your child might have hypertrophic cardiomyopathy, he or she can order tests. These can include:

●An “electrocardiogram” (also called an “ECG” or “EKG”) – This test measures electrical activity in the heart (figure 2). It can show if the heart is beating in a normal pattern and rhythm. The doctor might have your child exercise during the test.
●An “echocardiogram” (also called “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.
●A Holter monitor – This is a small, portable machine your child wears (figure 4). It records the heart’s electrical activity over 1 or 2 days. It can show heart rhythm problems that can be dangerous.
Depending on your child’s situation, he or she might need other tests, such as:

●Cardiac catheterization (also called “cardiac cath” or “coronary angiography”) – During this test, the doctor places a thin plastic tube in a blood vessel in your child’s leg and moves the tube up to the heart. The doctor can also put dye into the heart through the tube. This test 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 has a parent, brother, or sister with hypertrophic cardiomyopathy, the doctor might suggest your child get tested for it. He or she might need tests every year between the ages of 12 and 20. People older than 20 do not need tests as often.

How is hypertrophic cardiomyopathy in children treated? — If your child does not have symptoms, he or she 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.
●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.

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? — A few people with hypertrophic cardiomyopathy get serious heart problems, but most people can live normal lives. Your child might need regular exams and tests, medicines, or other treatments. He or she might need to avoid certain foods or activities.

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