In some cases, another type of echocardiogram, transesophageal echo(or TEE), may be performed. In summary, patients with HCM may suffer from LVOTO obstruction, atrial arrhythmias, SCD, and advanced heart failure. Most people with HCM have few or no symptoms. During this procedure, your healthcare provider locates the small coronary artery that supplies blood flow to the upper part of your septum. Diagnosing Hypertrophic Cardiomyopathy . If you have a first-degree relative a parent, sibling or child with hypertrophic cardiomyopathy, you might be referred for genetic testing to screen for the condition. In some cases, drugs may also play a role in causing fatigue. Hypertrophic cardiomyopathy affects an estimated 600,000 to 1.5 million Americans or 1 in 500 people. Know what to expect if you do not take the medicine or have the test or procedure. Some people with hypertrophic cardiomyopathy dont have symptoms while others may only feel symptoms with exercise or exertion. People with severe symptoms and poor heart function. Nature Clinical Practice Cardiovascular Medicine. AskMayoExpert. Your heart beats faster and pumps harder, and may circulate two to four times as much blood each minute as it does on a cool day. Hypertrophic cardiomyopathy (HCM) is a complex type of heart disease that affects your heart muscle. Patients with HCM are at increased risk for SCD, and risk stratification for implantable cardioverter defibrillator (ICD) implantation is critical in this population. It's important to take the medications that have been prescribed by your health care professional. Get useful, helpful and relevant health + wellness information. 2010;152 (8):513-520. Commonly affected genes include 12: However, hypertrophic cardiomyopathy is the most common cause of sudden cardiac death in people under age 35. At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. But some do, especially if their disease is more severe. Septal reduction therapy (SRT) is indicated when medical therapy fails to control NYHA Class III symptoms or following LVOTO-associated syncope or near syncope refractory to medical therapy. Screening typically includes a history, physical exam, electrocardiogram (ECG) and an echocardiogram. Heart problems, such as hypertrophic cardiomyopathy (abnormally thickened heart muscles), could cause panting. People with HCM may need to make lifestyle changes, such as limiting their activity, to adjust for their disease. The heart muscle cells enlarge more than they should and scarring often develops between the cells. HCM has been regarded as the most common cause of sudden cardiac death in young people and competitive athletes in North America, although it is rare. Your healthcare provider can help identify ways to reduce your risk. Take all your medicine as prescribed. Find more information on our content editorial process. The abnormal heart muscle seen in cardiomyopathy is not caused by blocked arteries in the heart (coronary artery disease), high blood . Some people who have the hypertrophic cardiomyopathy gene may never develop the disease. The interventricular septum is the heart muscle wall that separates the two ventricles (two lower pumping chambers of the heart). Up to one-fifth of young athletes (aged between 14-35 years) reveal greater left ventricular (LV) wall thickness compared to sedentary controls, though the majority fall under 12 mm. National Heart, Lung and Blood Institute. Hypertrophic cardiomyopathy (HCM) is an inherited disease of the cardiac sarcomere that results in left ventricular hypertrophy, hyperdynamic function, microvascular dysfunction, impaired relaxation, and myocardial fibrosis.1 Clinical hallmarks include left ventricular outflow tract obstruction (LVOTO), arrhythmias, and heart failure.2,3 To date, no disease-modifying therapies have been identified, although clinical trials of novel therapeutics are in progress.4,5 This analysis focuses on HCM management strategies fundamental to the care of patients with HCM: LVOTO, sudden cardiac death (SCD), atrial fibrillation, exercise restriction, and heart failure. People with hypertrophic cardiomyopathy are at increased risk of developing bacterial or infective endocarditis. It happens to all of us. Although this type reduces the amount of blood your ventricle can handle, it doesnt keep blood from moving. As HCM progresses, it can cause other health problems. They may want to investigate possible HCM-related causes of your fatigue. Hypertrophic cardiomyopathy (HCM) is a genetic condition that causes the left ventricle of the heart to become thick and stiff, preventing blood from circulating. Also, some insurance companies don't cover genetic testing. We do not endorse non-Cleveland Clinic products or services. Try having slightly cooler water in your shower or bath. HCM occurs in about 1 in 500 people and affects both children and adults. HCM causes abnormal growth of the heart muscle. White patches in your mouth or on your tongue. Mayo Clinic. Bristol Myers Squibb is proud to support the American Heart Association. A) True B) False Click the card to flip Definition 1 / 67 A) True Click the card to flip Flashcards Learn Test Match Created by Terms in this set (67) True or False? The risks and complications of heart surgery increase with age. This is reflected in the 2018 United Network for Organ Sharing (UNOS) allocation guidelines for heart transplantation, which affords HCM patients higher outpatient priority listing at Status 4 than other outpatient transplant candidates with ischemic or dilated cardiomyopathy, who are Status 6.22, There are currently no medical interventions that alter the natural course of HCM, but cardiac myosin inhibitors have shown potential promise.4,5 Trials investigating the effect of cardiac myosin inhibitors such as mavacamten (EXPLORER-HCM and MAVERICK-HCM) and CK-274 (REDWOOD-HCM) on LVOTO and HCM associated diastolic heart failure are underway. 1 clinical hallmarks include left ventricular outflow tract obstruction (lvoto), arrhythmias, and heart failure. HCM also may cause thickening in other parts of your heart muscle, such as the bottom of your heart (called the apex), right ventricle or throughout your entire left ventricle. A-Z of heart and circulatory diseases Cardiac arrest Coronary heart disease Catecholaminergic polymorphic ventricular tachycardia Familial hypercholesterolaemia Heart attack Heart failure Heart murmurs Heart valve disease Palpitations Pericarditis Stroke Takotsubo cardiomyopathy Women and heart attacks Cost of living support Heart Helpline Mutations in a group of related genes that make up the cardiac sarcomere are found in up to 60% of individuals with a family history of HCM and 30% of those without a family history. Feeling tired is common. It can also lead to sudden cardiac arrest, but this is rare. This is because some blood pressure medications can worsen obstruction in certain people. For people with HCM who dont have symptoms, a heart healthy lifestylewhich includes staying active, eating a healthy diet, maintaining a normal weight, getting good quality sleep and not smoking is recommended. It usually affects the left ventricle, the chamber of the heart responsible for pumping oxygenated blood to the body. When temperatures soar, perspiring can put a strain on your cardiovascular system, too. 1. The American Heart Association is a qualified 501(c)(3) tax-exempt organization. If you have heart failure, it doesnt mean your heart has failed or stopped working. They insert a balloon catheter into the artery and then inflate the catheter. Eat Healthfully Eating a healthy diet can improve heart health. Fatigue is one of the most common symptoms of HCM. Circulation. The thickened septum may bulge into the left ventricle and partially block the blood flow out to the body. Take light meals; avoid hot heavy meals and reduce the use of your oven to keep your rooms cooler. Researchers are still trying to understand what other factors increase the chances of having the disease. Common symptoms of hypertrophic cardiomyopathy include: The majority of people with hypertrophic cardiomyopathy live a normal life and dont experience health-related problems. This means something is wrong with a gene that codes the characteristics of the heart muscle. HCM causes heart muscle to thicken and heart muscle cells to become disorganized. Several tests may also help in the diagnosis. Health Library Events Donate / Volunteer Blog. Hypertrophic cardiomyopathy often goes undiagnosed because many people with the disease have few, if any, symptoms. Our online community of survivors and caregivers is here to keep you going no matter the obstacles. This surgical procedure frequently eliminates the mitral valve problem. We work too hard or exercise too hard. Adults who don't compete in athletics should be screened every five years. (These increase the risk of abnormal heart rhythms.). Weather-related closures; Nursing at SBL; Facebook Instagram LinkedIn Twitter. Hypertrophic Cardiomyopathy - Symptoms, Tests, Treatments Learn more from WebMD about hypertrophic cardiomyopathy, thickening of the heart muscle, including symptoms, diagnosis, and. Weve been there, and we wont let you go it alone. This means you need an abnormal gene from only one of your parents to have it. A single copy of these materials may be reprinted for noncommercial personal use only. Its etiology and pathogenesis remain undefined but the three principal factors implicated are a genetic predisposition, a hypersensitivity to catecholamines, and an abnormal . This is important even if you do not have any symptoms. Follow your healthcare providers instructions carefully. Please talk to your healthcare provider about the type and amount of antibiotics you should take, and for what procedures you should take them. Because HCM can be passed from parents to children, your physician will also want to know if anyone in your family has been diagnosed with HCM, heart failureor cardiac arrest. Search the website & HCM related abbreviations, Transvenous Implantable Cardioverter Defibrillator (ICD) Traditional, Subcutaneous Implantable Cardioverter Defibrillator (ICD), Pediatric cardiomyopathy MyClimb Natural History Study, Drill Dr. Heart Cardiac Arrest Preparedness, HCMA/AHA Co-Branded Appointment Rack Card, HCMA: Tales from the Heart Podcast Archive, AHA HCM Sudden Cardiac Death Calculator, https://www.mayoclinic.org/symptoms/fatigue/basics/definition/sym-20050894. In addition, disopyramide may be used when first-line medical treatments fail, and a new medication called mavacamten is being evaluated by the FDA. But even if you have HCM, not all of your fatigue is necessarily due to HCM! It can also be a symptom of other diseases like anemia, anxiety disorders, COPD, COVID-19, diabetes, depression, hyperthyroidism, hypothyroidism, multiple sclerosis, obesity, stress, sleep apnea, or traumatic brain injury. Have someone take you to receive medical attention if fatigue is accompanied by abnormal bleeding or severe headache. The risk of heart complications can vary between families and among different members of the same family, so its important that your health care team identifies people who are most at risk for these complications so preventative treatment can be provided. . "If you can get heat to penetrate areas where you have pain, you increase blood flow and can loosen up tight ligaments, tendons and connective tissue." Reviewing your diet. The two can be related - fatigue can certainly be depressing! Although hypertrophic cardiomyopathy (HCM) is a disease, which is known almost 60 years, change of opinions on the condition has occurred many times in history, and sometimes there has been 180-degree turn around. Find more COVID-19 testing locations on Maryland.gov. 2021; https://pubmed.ncbi.nlm.nih.gov/. Complications of hypertrophic cardiomyopathy can include: There is no known prevention for hypertrophic cardiomyopathy. Most people with hypertrophic cardiomyopathy (HCM) lead normal lives, but several treatments are available for people who develop symptoms or are at risk for serious problems. American Heart Association. Heat fatigue symptoms include cool moist skin, a weakened pulse and feeling faint. 2023 American Heart Association, Inc. All rights reserved. HCM is autosomal dominant. If genetic testing isn't done, or if the results aren't helpful, then a health care provider might recommend repeated echocardiograms if you have a family member with hypertrophic cardiomyopathy. (PDF). 3. If you have HCM, see your healthcare provider regularly for monitoring. Some people need medicines or surgical procedures. Swelling in your ankles, legs and abdomen. People with hypertrophic cardiomyopathy who have a higher risk for sudden cardiac death include: Ask your healthcare provider about your personal risks. The stiffness in your left ventricle causes pressure to increase inside your heart and may lead to symptoms such as: When your left ventricular outflow tract becomes narrow, your mitral valve doesnt work properly. Make a donation. Sore throat, scratchy throat or pain when swallowing. *Mavacamten is not in the current 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients with Hypertrophic Cardiomyopathy, as it was FDA approved in 2022. Accessed Dec. 9, 2021. Arrhythmias may also mean that some of your tissues are not getting enough blood. Predictors of Long Term Outcomes in Symptomatic Hypertrophic Obstructive Cardiomyopathy Patients Undergoing Surgical Relief of Left Ventricular Outflow Tract Obstruction. Mutations in a group of related genes that make up the cardiac sarcomere are found in up to 60% of individuals with a family history of HCM and 30% of those without a family history. 10. Passing urine may also decrease and vomiting may occur. 2007; doi:10.1038/ncpcardio0965. Hypertrophic cardiomyopathy (HCM) is a primary myocardial disease that primarily affects left ventricular (LV) myocardium and is characterized by mild to severe thickening (concentric hypertrophy) of the LV wall (septum and/or free wall) and papillary muscles. Hypertrophic cardiomyopathy (HCM) is a condition in which the heart muscle becomes thick. When the weather is warm, your heart needs to work harder to pump blood to the surface of your skin to assist with sweating to cool your body. Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Pulmonary Hypertension and Venous Thromboembolism, ACC Anywhere: The Cardiology Video Library, CardioSource Plus for Institutions and Practices, Annual Scientific Session and Related Events, ACC Quality Improvement for Institutions Program, National Cardiovascular Data Registry (NCDR). If you want to warm yourself up in cold winter nights, then hot shower is the best option. Hypertrophic cardiomyopathy (HCM) is a form of heart disease that involves thickening (hypertrophy) of the heart muscle, most commonly involving the interventricular septum. It most often affects the wall (septum) between your right and left ventricles, which are the heart's lower chambers. Also know what the side effects are. https://www.cardiosmart.org/topics/hypertrophic-cardiomyopathy. This is a normal response and is seldom a medical emergency. The ICD is a small device placed just under your skin and is connected to wire leads that are threaded through the vein to your heart. Talk with your cardiologist. Find a treatment specialist Find treatment locations Some estimates say one out of every 200 people has HCM Hypertrophic cardiomyopathy often goes undiagnosed, especially earlier in life. Butternut squash and carrots add a natural sweetness to this creamy soup. Know the reason for your visit and what you want to happen. Also write down any new instructions your provider gives you. Know why a new medicine or treatment is prescribed, and how it will help you. The thickened septum may cause a narrowing that can block or reduce the blood flow from the left ventricle to the aorta a condition called outflow tract obstruction. Seek support. The heart muscle cells enlarge more than they should and scarring often develops between the cells. Narrative review: harnessing molecular genetics for the diagnosis and management of hypertrophic cardiomyopathy. "Hanshu food and goods" records: "wine, the beauty of the sky, the emperor so nourish the world, enjoy the sacrifice to pray for . The most common presenting symptom of hypertrophic cardiomyopathy is dyspnea. Risk identification and regular follow-up. To better manage your condition: Manage stress. Fluid accumulates in the legs or the lungs. The patient reports using cocaine a "couple of times" as ateenager. First understand the wine. A fever over 100 degrees F, sweats or chills. Contact Us, Hours The parts of the heart most commonly affected are the interventricular septum and the ventricles. Strenuous exercise has been routinely discouraged,6 though there is an increasing appreciation for how the health benefits of exercise should be balanced with the potential risks.20 Studies to better define the risk of high-intensity exercise in HCM are ongoing (LIVE-HCM/LQT), and thoughtful discussion with shared decision making is a widely accepted strategy for application of exercise restrictions in this population. People who are fatigued feel as if they have no energy or motivation. Your heart fails to push blood through the system adequately, or it fails to fill properly. The thickened wall might block blood flow out of the heart. GeneReviews. C. History Part 3: Competing diagnoses that can mimic hypertrophic cardiomyopathy. 6. People with hypertrophic cardiomyopathy also have a rearrangement of heart muscle cells (myofiber disarray). Eliminate or limit physical activity during the hottest parts of the day and do light exercise during the cooler hours. Anesthesiology January 2006, Vol. Sometimes the cause of hypertrophic cardiomyopathy is unknown. Cellular changes. Hypertrophic cardiomyopathy is usually passed down through families (inherited). This can cause fluid to build up in the lungs. Mayo Clinic. Find more information on our content editorial process. If you are fatigued, you may also be sleepy, but sleeping won't make you feel less fatigued. HCM patients can have almost any medical problem that anyone else can! *All health/medical information on this website has been reviewed and approved by the American Heart Association, based on scientific research and American Heart Association guidelines. Closed on Sundays. There are many genes that can cause hypertrophic cardiomyopathy. Watch out for thirst, giddiness, dizziness, weakness, lack of coordination, nausea, profuse sweating, and cold or clammy skin. These changes can sometimes make your heart-related symptoms worse and can sometimes affect how heart copes with everyday things. HYPERTROPHIC cardiomyopathy (HCM) is a genetic cardiac disorder caused by mutations in one of at least 12 sarcomeric or nonsarcomeric genes and is recognized as the most common cause of sudden cardiac death (SCD) in the young and an important substrate for disability . You may need to speak to your GP or heart nurse if you are taking diuretics and you are concerned about safe levels of fluid intake during a period of hot weather. Because there are so many causes of fatigue, there is no simple answer or single treatment. Prevention and Treatment of Cardiomyopathy. hypertrophic cardiomyopathy (hcm) is an inherited disease of the cardiac sarcomere that results in left ventricular hypertrophy, hyperdynamic function, microvascular dysfunction, impaired relaxation, and myocardial fibrosis. Adolescents and competitive athletes should be screened once a year. It is important to always check with your GP or cardiologist for advice if you are on a fluid restriction and youre concerned about your fluid intake during a period of hot weather. Fluid accumulates in the legs or the lungs. Interventions and Structural Heart Disease, Hybrid Versus Catheter Ablation in Persistent Atrial Fibrillation, Clinical Outcomes of Conduction System Pacing Compared to Biventricular Pacing in Patients Requiring Cardiac Resynchronization Therapy, Spike Protein Detected in PostCOVID-19 mRNA Vaccine Myocarditis, PCSK9 Inhibition During Inflammatory Stage of COVID-19 Infection, Treatment of Radiation-Induced Aortic Stenosis: Key Points, Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Pulmonary Hypertension and Venous Thromboembolism. Other people with hypertrophic cardiomyopathy may develop heart conditions that shorten life or decrease their quality of life, including: Sudden cardiac arrest is a sudden loss of heart function caused by a dangerously fast heartbeat (ventricular tachycardia). "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Saturday: 9 a.m. - 5 p.m. CT Correlations between physician-perceived functional status, patient-perceived health status, and cardiopulmonary exercise results in hypertrophic cardiomyopathy. Diagnosis is typically done by echocardiogram. Your doctor will listen to your heart and lungs with a stethoscope. The alcohol causes these cells to die. In most cases, the symptoms first appear during adolescence or young adulthood. Dr. Nicholas Smedira speaks with Dr. Kevin Hodges about how his passion for patients with HCM pairs with one of his other specialty areas, the mitral valve. Abstract. Your healthcare provider might recommend other lifestyle changes, like losing weight, quitting smoking, or improving your diet. Its possible to have normal test results even if hypertrophic cardiomyopathy runs in your family. If your symptoms are gradually increasing, plan to see your healthcare provider soon. (a) shows the electrocardiogram of the proband with HCM from family A (II: 3); the Q-wave was abnormal in sidewalls and the T-wave is changed; (b) shows the electrocardiogram of the proband with DCM from family B (II: 3); it reveals a significant ST-segment depression. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Video: Septal myectomy and apical myectomy, Implantable cardioverter-defibrillators (ICDs), Sharing Mayo Clinic: A heart patient's fall picks up something big, Sex and race disparities found in management of patients with hypertrophic cardiomyopathy in the hospital, Mayo Clinic Q&A podcast: Justin's journey and silver linings, Mayo Clinic Q and A: Hypertrophic cardiomyopathy. The thickened areas can block the ventricles (the lower chambers of the heart), making it harder for the heart to pump blood. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Mayo Clinic is a not-for-profit organization. Hypertrophic cardiomyopathy is most often caused by abnormal genes in the heart muscle. Your heart fails to push blood through the system adequately, or it fails to fill properly. HCM may also lead to heart failure. When. Hypertrophic cardiomyopathy (HCM) in cats is a heart condition that may cause heart muscles to thicken. Dearani JA, et al. 2020 AHA/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: Executive summary. We are vaccinating all eligible patients. Kirklin JW, et al. A parent with an abnormal gene for this condition, has a 50% chance of giving that gene to a child. Current therapies focus on the disease manifestations, but future therapies may offer hope to effectively address the pathophysiology of HCM. Most people who have it can have a normal life, but it can be serious for some people. These may include: Your healthcare provider will take your medical history and do a physical exam, noting any heart murmurs. Most people with HCM have few or no symptoms. Take Hot Showers Together Or Lay In Bathtub. Hypertrophic cardiomyopathy is most often inherited and is the most common form of genetic heart disease. Hypertrophic cardiomyopathy happens when the heart muscle grows too thick. Thickening of your heart muscle (especially the ventricles or lower heart chambers). 2. Cardiomyopathy . Skip to Content (217) 258-2525. They may prescribe a sleep study, or ask questions that may suggest that other tests or specialist consultations are warranted. Hypertrophic cardiomyopathy typically affects the muscular wall (septum) between the two bottom chambers of the heart (ventricles). Read Dr. Kevin Hodges' biography Learn more about hypertrophic cardiomyopathy Being diagnosed with hypertrophic cardiomyopathy can cause a range of difficult emotions. A TEE is done using a probe inserted in the throat while the patient is under sedation. The patient has a history of a recent upper respiratoryinfection. Heat exhaustion occurs as a warning that the body is getting too hot. Some general types of treatment include: Septal myectomy and alcohol septal ablation may be done in people with severe symptoms or complications that do not improve with medicines. They may want to investigate possible HCM-related causes. Chapel Hill approved short-term rental rules in 2021. Accessed Oct. 25, 2021. Wang L. Seidman JG, Seidman CE. Modern treatments such as medications, surgery, and implantable cardiac . Your outlook (prognosis) depends on how well your heart muscle is working, your symptoms, and how well you respond to and follow your treatment plan. (PDF), Fill out a discussion guide online to print and take to your appointment. Body temperature may still be normal, and your pulse can be normal or raised slightly. This blocks outflow (obstruction) and increases pressure in your left ventricle. The alcohol kills the cells on contact, making your septum shrink back to a more normal size over the following months. 2,3 to Hypertrophic cardiomyopathy (HCM) is a heritable, autosomal dominant disorder of structural abnormalities confined to the heart. The patient has a family history of coronary artery disease(CAD). Call 911 or your local emergency number if you have any of the following symptoms for more than a few minutes: Hypertrophic cardiomyopathy is usually caused by changes in genes (gene mutations) that cause the heart muscle to thicken. Hypertension is defined as a sustained elevated blood pressure above the accepted norms of 140 mm Hg systolic or 90 mm Hg diastolic. But in some people, it can cause more serious heart problems and in rare cases can cause sudden death. Hypertrophic cardiomyopathy (HCM) is a medical condition that may be passed on from generation to generation. Mayo Clinic does not endorse companies or products. Hypertrophic cardiomyopathy (adult). Heat cramps can cause muscle spasms in the abdomen, arms, or legs after exercise. In many cases, hypertrophic cardiomyopathy is caused by a mutation in one of the genes that make up the cardiac sarcomere, and only a single copy of a defective gene is needed for the disorder to develop (autosomal dominant inheritance). Heart failure symptoms, like shortness of breath, leg swelling, and fatigue, can occur in addition to exercise intolerance in HCM. (2020, July 22). Hypertrophic cardiomyopathy care at Mayo Clinic. Avoid getting too warm if you can, try and stay out of the sun and don't go out between 11am and 3pm if you are vulnerable to the effects of warmer weather. Arrhythmias may also mean that some of your tissues are not getting enough blood. Other diagnostic tests may include: Confirming diagnosis or preparing for surgery may also involve one or more medical procedures duringcardiac catheterization. Pets and Your Health / Healthy Bond for Life, La Iniciativa Nacional de Control de la Hipertensin, What is Hypertrophic Cardiomyopathy? The most fundamental change concerned the prognosis of HCM. Bacterial or infective endocarditis is an infection of your heart valves or your hearts inner lining (endocardium). Cardiologist Shares Their Experience With Heart Failure . They may prescribe a sleep study, or ask questions that may suggest that other tests or specialist consultations are warranted. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Hypertrophic cardiomyopathy may be best known for its role in cardiac arrest and death in some young professional athletes.
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