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kenneth Find out more about kenneth
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    Hello. My name is Kenneth and I'm new to this board. I was diagnosed with HCM about 2 years ago. I have a long family history of sudden death so I had an ICD implanted last year. I'm now on Toprol xl, Cozaar, and Dialtilzem 2x daily. I deal with daily symptoms of chest pains, shortness of breath, and fatigue. I see a specialist at the medical center in Houston.

    I have my annual echo scheduled for next week and I have a few questions that some of you might be able to help with. What is considered normal septum thickness? What is gradient? Does an echo show blood flow or rescriction? My dr. doesn't think that my chest pain is related to HCM but I've read here that many of you have chest pain also. Could the chest pain be related to the rescriction of blood flow? Any info on what to ask my dr. or what to look for on my echo would be appreciated. Thank you all for helping to educate everyone on this condition.

  • #2
    Hi Kenneth, I'll give you my 2 cents worth as I'm sure others will.
    You can also go back thru past postings and get your answers.
    Normal Septal thickness is 1.1 - 1.2 mm, mine is 2.1 and anything over 3 make the HCMer a candidate for an implantable defibulator.
    Gradient pressure is the pressure difference between the inside of your heart and and the outside thru the mitral valve. No gradient is good and usually indicates no obstruction which is my case. A high gradient llike 80-100 usually means there is an obstruction and therefore the heart has to work even harder to get the blood out, the result being an enlarged heart.
    If the obstruction is severe enough there are a couple procedures, one where they will surgically remove a portion of the muscle and the other they use alcohol to kill off the area of obstruction, there are many posting from people who have had good results from both procedures.
    The echo would show obstruction, where and how bad and also blood flow.
    Chest pain is fairly common with HMCers as the heart is not as efficient as a normal heart and must work harder and there are times when the heart itself is calling for more blood and it cannot efficiently supply it.
    Hope this helps some, I'm sure other will also post and that should give you a pretty good understanding.
    Every great thing that has ever happened since the beginning of time has started as a single thought in someones mind.
    So if you are capable of thought then you are capable of great things
    Good luck and stay well.


    • #3
      Hello Kenneth. My name is Nancy and I had a septal myectomy in Sept. 2002 at the Cleveland Clinic. I've suffered with terrible chest pain for many years. (I'm 42 yrs. old.) I have been told more times than I can count..."Your chest pain isn't coming from your heart".Sometimes it would hurt all day and I would end up in bed for the day on pain killers and then I'd be very weak the next day. This could occur without anything that I could think of to cause it and some days (the worst ones) I would just wake up hurting. I persoanlly always thought that the way the cell structure was disarrayed (not lined up like bricks but sort of cast in every direction) was causing a poor oxygen flow thru the heart tissue. And to some extent this is probably true. BUT, since I've had my myectomy I haven't experienced any of my old familar chest pain. I've had a twinge or two here or there but nothing long lasting. Going into the surgery I really didn't think that it would relieve my chest pain (because I thought it was caused at the cellular level).But thank God since the obstruction (Restriction) of the blood flow has been removed the chest pain is gone! Even the HCM specialist I saw didn't think my chest pain was due to my heart so don't be suprised if you contine to hear that. Our pain doesn't always fit their mold of chest pain, but as you have read many of us have this symptom. This is a post about my experience with chest pain and I'm sure that everyone's experience will be different. One thing about HCM...It's never quite the same from person to person.Your echo will show how the blood flows from your heart and if you have a gradient. A gradient is sort of pressure building up in you heart due to the obstruction. Normal septum sixe is 1cm I think. If the septum is larger it can cause an obstruction that would prevent the blood from flowing out of the heart as it should, then you get a pressure gradient in the heart. Most of the symptoms can occur with or without obstruction. After your echo, ask for a copy of your report then you can have it for future questions and answers. I hope this has helped.
      Obstructive HCM, Pacemaker 1999, Septal Myectomy 2002


      • #4
        Hi Kenneth..

        You should give the HCMA office a call at 973-983-7429 and leave a message for Lisa...or you can email her directly at [email protected]. She is not feeling very well and may be a little slow in getting back to you. But she should be able to answer all of your questions.



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