My sister recently went to hospitail complaining of shortness of breath, she was admitted & released after 5 days . They gave her respitory treatments, her blood pressure was high , they got it down. They determine she had a heart condition but needed more tests. I don't know if she is on any meds. but she has sickle cell, she is anemic, she is about 5' 8" & 130 lbs. & seems to be losing wieght. A doctor just told her she had thick walls in her heart but didn't give her data on the conition. Can it be reversed, how can it be treated, should she be looking for donor?
For some insight: The heart wall thickens to accomplish work at a higher workload, just as other muscles in our body thicken when we are forcing them to do heavy labor on a chronic basis. High blood pressure inicates the heart is pumping against higher resistance of the blood vessels (can be occluded or abnormally constricted). The heart begins to stiffen, abnormal heart rhythms become more common, the chambers dilate and ultimately the heart begins to fail. Excess thickening of the left ventricle is called hypertrophy and can increase the possibility of sudden death. Worst case scenario if not successfully treated.
Generally, when the need for higher pressures is relieved as it relates to high blood pressure the process is reversed, and the heart thickness returns toward more normal. This is what is expected to happen with the control of high blood pressure.
There could be other reasons for the heart to enlarge such as a heart valve disorder, congenital defects, etc. Often these conditions can be effectively treated as well...may require surgery.
Excessive thickening of the heart is related to two general mechanisms. The first is a need to generate high pressure either due to hypertension, or a mechanical blockage (stenosis of a blood vessel or valve). Through a complex mechanism of chemical interactions the body is able to stimulate muscle growth dependant upon its need. In the case of essential hypertension (the most common variety of high blood pressure), the walls of the heart thicken to provide for the chronic pressure overload. This is accomplished by series of chemicals called growth factors (local growth hormones). Some people produce more of these then others, some are more resistant to their actions for many reasons, some of which are genetic. Thus, some people with very high blood pressure will have hearts that have not thickened, others with more modest blood pressure will have responded by more thickening of the muscle. .
The second mechanism is totally due to heredity. There are probably several genes responsible for this propensity to increase the thickness of the heart. In each, the heart responds to local growth hormones to thicken. In some, it is likely due to an excess of locally produced growth hormones, in others due to an oversensitivity of the body to normal amounts of such hormones causing the muscle to thicken. The most common example of hereditary causes for heart muscle thickening is what we call hypertrophic cardiomyopathy (other names for the same problem are HOCM: hypertrophic obstructive cardiomyopathy or IHSS idiopathic hypertrophic subaortic stenosis); another less common problem is called Fabry's disease. Although these problems have a genetic cause they are medically treatable conditions.
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Hypertrophic Cardiomyopathy can be obstructive (HOCM) or it can be non-obstructive (HCM) and as the above poster wrote; sometimes it is referred to as IHSS (Idiopathic (cause unknown) Hypertrophic (thickened) Subaortic (below the Atria) Stenosis (narrowing) ). This disease can be genetic or it can be sporatic. Therefore all close family members should have echoes to rule it out or confirm it. Not all patients start off with hypertrophied hearts and end up with thinned walls, only a small percentage of patients actually end up having that happen. SCD (Sudden Cardiac Death) is rare, but does happen in about 2% of the population due to arrhythmias which are caused by an irritated thickened heart muscle. Some patients can live many years with this disease, some die young and a small percentage of patients are transplanted if the disease is very severe (Grade III- Grade IV Classification). Patients have chest pain, are short of breath (SOB) and have dizziness and fatigue, sometimes severe. Hope this helps.
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