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Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy sounds like a big scary thing – and it is. The more common name, Sudden Death Syndrome, indicates that it’s one of those things that ‘does what it says on the tin’. Sometimes it’s called Sudden UNEXPECTED Death Syndrome and for good reason – in the vast majority of cases you don’t know you’ve got the problem until it attacks you, by which time it’s too late.

It’s even more unexpected because the sort of guys who fall over and die from it are generally very fit, normally healthy, athletic types. The most high-profile recent example is Bolton footballer Fabrice Muamba (who was incredibly fortunate to survive) but the fact is that HOCM, as it’s also known, kills hundreds of young athletes (mostly male) every year.

There are other heart-related problems and causes of death in young people, but HOCM is the most common affecting 1 in every 500 of the population, men and women, with no particular ethnic bias.

+   What happens?

It’s quite simple. One moment there you are playing football or rugby to a high standard, the next minute ‘bang’ – you’re gone. Basically your heart stops.

+   What causes it?

HOCM is caused by a thickening of the heart muscle – often only on one side. This makes it harder for the blood to be pumped around the system. Excessive muscle thickening tends to develop at puberty or young adulthood. Like any muscle the harder you work the heart the stronger it will get. Because today’s young athletes train super-hard the hearts of those who might be prone to HOCM are likely to develop the problem more acutely.

+   Symptoms

The tragic problem with young athletes is that the first symptom is sudden collapse, often resulting in death from the blockage of blood to the rest of the body. Around half of the deaths that occur happen during or just after strenuous exercise.

Of course whilst 1 in 500 people have it not 1 in 500 die of it. If you’re lucky you will have symptoms that mean you get the chance to go and see your Doctor. Here’s what to look out for:

  • Chest pain
  • Dizziness
  • Fainting – especially during exercise
  • Fatigue
  • Light-headedness
  • Heart palpitations (where you can feel it beating)
  • Shortness of breath with activity or even after lying down or being a sleep for a while

+   Prevention

If you don’t have any symptoms a critical attack of HOCM is impossible to prevent. If you collapse it’s not very easy to treat unless like Muamba you happen to have a leading heart surgeon in the crowd.

You can however have a physical ‘pre=performance’ screening test that will indicate if you might be at risk. In some countries (such as Italy and the USA) this is compulsory for young athletes before they take to the pitch. As the condition can develop at different times Italian sportsmen and women have to pass the screening every year.

Some sports in the UK are starting to bring in screening for young elite athletes. If not you can pay privately for a screening – it can cost around £35. If you have ambition to play big-league sport and train intensively it’s not a lot of money for peace of mind.

HOCM tends to run in families so if you have a relation who you know has had the problem then think seriously about getting the tests.

+   Treatment

There is no cure for HOCM so any treatment offered will be around managing your lifestyle so as to lower your risks. If you do have symptoms you will almost certainly be advised not to undertake strenuous activity or competitive sport. Drugs are available and in some cases surgery is recommended. Every case is slightly different and your medical team will give you a plan that is best for you. You’ll almost certainly have to have an annual check-up to help manage your condition.

+   During an attack

If you’re playing sport and somebody collapses call the emergency services immediately.

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