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Welcome to your 40's... you have HCM?


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mtlieb Find out more about mtlieb
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  • Welcome to your 40's... you have HCM?

    So anyway...

    I've been following the boards pretty closely for several years now, and from what I've observed there is a large percentage of us who have been diagnosed and/or had our symptoms take a dramatic turn for the worse somewhere around our late 30's early 40's. Furthermore, it seems that us late-bloomers tend to make up the bulk of the obstructed HCM population with large gradients that required intervention (myectomy, ablation, norpace, etc.)

    There are exceptions of course, since we obviously do have younger HCM'ers who are obstructed and older members who aren't. But in general it appears that the vast majority of us fall into two categories: We're either diagnosed young with a fairly thick septum but no obstruction... or we're diagnosed older with significant obstruction but with a lesser degree of hypertrophy than our younger counterparts.

    What's the correlation here?

    "Some days you're the dog... some days you're the hydrant."

  • #2
    I don't know what the answer is or why this is the case, but I definitely fit into this category. I was diagnosed in my early to mid 30s with no gradient at all, and a septum of 1.5 or so. Next echos were similar until I got pregnant at 35, and gradient worse, septum thicker. Now septum seems to be 1.8, but gradients have ranged from negligible to 120 or so. I failed beta blocker therapy and now am taking Norpace and beta blockers.
    Daughter of Father with HCM
    Diagnosed with HCM 1999.
    Full term pregnancy - Son born 11/01
    ICD implanted 2/03; generator replaced 2/2005 and 2/2012
    Myectomy 8/11/06 - Joe Dearani - Mayo Clinic.


    • #3
      I think I was diagnosed around age 29 or 30. I would get occasional palpitations but did pretty well. I was 49 when I started getting AFIB (2 years ago), but other than that, I feel pretty good (but not as good in the hot, humid weather!). I think it varies so much with each individual...some symptomatic at an early age and others not until they are in their 40's or even later.
      \"It is not length of life, but depth of life.\"

      Ralph Waldo Emerson


      • #4
        Good Question! I was dx, in my late 30's & stayed very manageable (with meds)-until, it was like I just woke up one morning & nothing would ever be the same again! I went from a constant gradient of 35 to 85 & then it kept getting worse, until within 6 months I had no choice, but to end up on the Table. What set this into motion? Why did I go for so many years being OK to being unable to function? I did not slowly get worse (noticeabley) just BAM.
        My Docs have not been able to provide an acceptable answer, maybe we can!


        • #5
          There seems to be unknown triggers to the evolution or expression of the disease and multiple variants to the genetic patterms. Some get it young some get it in the middle years and some when they are older. Some also go undiagnosed their entire life. Some families find out when their loved ones suddenly die.
          There is still so much unknown about this disease that we know so much about.
          Dx @ 47 with HOCM & HF:11/00
          Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
          Lead failure,replaced 12/06.
          SF lead recall:07,extracted leads and new device 2012
          [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
          Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
          Genetic mutation 4/09, mother(d), brother, son, gene+
          Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin


          • #6
            While I see your point but I have to disagree. The point you are making is based on what you see here on a message board, not everyone within the HCMA is here on this board and you will notice that the cluster of people you see here are of similar age mostly due to the fact that this is the "Internet-information" generation. We are contacted via phone and mail by a different demographic and if we were to break down age of diagnosis vs the type of communications each uses you will see a big jump in the 30-45 yrs olds on the web. It is normally those who are affected themselves here on the web. Via the phone I speak to more parents and late teens and 20 somethings. By mail we hear from the over 65 group.

            There is a jump in numbers of people diagnosed in the 30-40's however if you would have done an echo on these people in there teens you would have found HCM in a staggering number of them. The issue to me on this matter is how do we get people to diagnose earlier because if we can do that it appears..APPEARS... that we can protect the heart from unnecessary damage over time.

            Again I am brought back to the A word... AWARENESS!!

            That's my 2 cents...
            Knowledge is power ... Stay informed!
            YOU can make a difference - all you have to do is try!

            Dx age 12 current age 46 and counting!
            lost: 5 family members to HCM (SCD, Stroke, CHF)
            Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
            Therapy - ICD (implanted 97, 01, 04 and 11, medication
            Currently not obstructed
            Complications - unnecessary pacemaker and stroke (unrelated to each other)


            • #7
              Originally posted by Lisa Salberg
              There is a jump in numbers of people diagnosed in the 30-40's however if you would have done an echo on these people in there teens you would have found HCM in a staggering number of them.
              Lisa, thanks... this is actually the point I'm trying to make. In fact, I'd always assumed that the majority of us older folks have had HCM since our teens but simply weren't diagnosed until later. Most of us do recall having symptoms at a younger age.

              My questions stem from the fact that those in our age group often experience a marked and sudden increase in symptoms at 40-ish years old, which seems to be the precipitating factor in either: a) first becoming diagnosed with HCM... or b) requiring more agressive intervention if already diagnosed. I was interested in hearing anyone's opinion on why this might be the case.

              Thanks much.

              "Some days you're the dog... some days you're the hydrant."


              • #8
                To further our discussion...

                I've been researching as many articles as I can find in order to determine the mean age of diagnosis for an HCM patient. Unfortunately, many journal abstracts do not contain this information and I don't have access to the full text. I'd especially like to find out what the mean age at diagnosis was for the Maron study (1101 patients) which is perhaps the largest study to date. One article by B.J. Maron, et al. in 2001 noted a mean age at diagnosis of 45 in a study of 480 individuals with HCM. This seems to back up what we see here on the board.

                I find this interesting more than anything else, and decided to start this discussion due to the fact that so many of the folks going for myectomies of late tend to be in the same age group. Not a scientific study of course, but it opens up an interesting discussion.

                "Some days you're the dog... some days you're the hydrant."


                • #9
                  It might also be the age when it becomes more acceptable to give in and acknowledge/admit to symptoms. Linda


                  • #10
                    In some cases - MINE- I was diagnosed at 18 but since I was so invincible and knew it, I shrugged it off as doctors not knowing what they were talking about. I, nor anyone in my family knew anything about the disease, computers were still big enough to fill an auditorium so no quick information was available. It took until I was 37 to get so obstructed and symptomatic to get re-diagnosed. It took me another week to even recall I had been diagnosed 20 years earlier. Good thing mom kept my medical records, it is all in there including EKG's and a full work up--of course it was I.H.S.S then.

                    NEMC's (Boston) First Myectomy 7-22-2003


                    • #11
                      Thanks for your input Doug, you were actually one of the persons (among many others) who I had in mind as I was starting this thread. Although you were diagnosed at a young age, your symptoms (obstruction) became markedly worse at the age of 37 as you said. There are many such cases like this on the board, with or without a prior diagnosis.

                      "Some days you're the dog... some days you're the hydrant."


                      • #12
                        My husband was diagnosed at 35 and now, at 40, he says he thinks the SOB and fatigue are getting worse. He isn't obstructed that I'm aware of. I think I finally have him convinced to go to a specialty center soon. I hope to get more answers soon.


                        Husband has HCM.
                        3 kids - ages 23, 21, & 19. All presently clear of HCM.


                        • #13
                          My obstruction symptoms became much worse when I hit 40 years old. I was diagnosed when I was 30 yrs. old.

                          When I was 39, I noticed much more SOB and fatigue and then when I turned 40, the symptoms became much worse. By 41 years old, I could barely make through the day and I was really suffering.

                          Just my experience.

                          49 yrs. old
                          Diagnosed at 31.
                          Cardiac Arrest 2003, RF Ablation in AZ, no positive result -
                          First ICD 2003 - In 2006 lead went bad, abandoned lead, threaded new one & new generator
                          Myectomy 5-5-05 at The Cleveland Clinic - Dr. Lever & Dr. Smedira -heart surgeon.
                          Currently have Grade 2 Diastolic Dysfunction with pulmonary hypertension & pulmonary edema.
                          My brother passed away suddenly at 34 yrs old from HCM.
                          2 teenage children, ages 17 and 15.


                          • #14
                            I was diagnosed when I was 20, but had symptoms when I was 17. Since I am OLD, this disease was very rare at that time. I had my first myectomy in 1973, then my second in 2000 when I was 47.


                            • #15
                              just to thow this post all off balance
                              i was diagnosed at 7 but didnt realy get any bad symptoms till i was maybe 15 ,and from there on it just got worst
                              but hey im not 40 yet so could realy speak from my side of it

                              Forever Young

                              I was diagnosedwith HCM at 6.
                              Went into Atrial fibrillation so had a ICD put in at 16
                              Went into Heart failure at 17
                              Got a heart transplant at 21(2009)


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