10 Steps to Protect Against Hypertrophic Cardiomyopathy

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By Dr. Robert Tozzi

Published February 11, 2013


As if it were yesterday, I recall the death of 18-year-old Ben Breedlove, who suffered from hypertrophic cardiomyopathy (HCM), an ailment in which I specialize as a pediatric cardiologist.

I have seen it rob too many young people unnecessarily of a long and fulfilling life.

Here are 10 steps to protect your children, family members and anyone you love against the ravages of hypertrophic cardiomyopathy:

1. Remember that statistically if one member of your family has been diagnosed with HCM, then one-half of your family members are at risk for developing this disease. Evaluation of first-degree relatives on a regular, repetitive basis can go a long way towards correct diagnosis and effective treatment. It is imperative to extend this medical information to as many relatives as possible. Try to make the effort to contact others, even if you are estranged from them. Remember to breed love.

2. Always remember that hypertrophic cardiomyopathy is a sneaky disease: It is many times missed or misdiagnosed. Common diseases that are confused with HCM are asthma, mitral valve prolapse, anxiety, coronary artery disease and an athletic heart.

3. Be aware of symptoms that require prompt medical attention:
• Chest pain with exercise or simple activities such as walking.
• Passing out is a very important symptom that requires prompt medical attention.
• Shortness of breath, lightheadedness, and extreme tiredness are other symptoms of HCM.

4. Avoid circumstances that increase your risk:
• Avoid hot weather and dehydration.
• Be aware of the need for vigorous fluid resuscitation during infections or gastroenteritis or exercise.
• Avoid burst of activity.
• Avoid isometric activity.

5. With hypertrophic cardiomyopathy in humans, the lining of the blood vessels in the heart tends to be affected. Unfortunately, this is not just limited to the heart, but also involves the blood vessels networked to other organs throughout the body:
• Foods that improve the lining of your blood vessel include nuts, seeds, dark chocolate, fruits and vegetables.
• Prolonged periods of walking help revitalize the lining of your blood vessels.
• Foods that decrease the function of the lining of blood vessels include sugary drinks (soda), high salt, high fat, high sugar, high fructose corn syrup, and even high protein. Life is about balance and a balanced diet.

6. Beware of diseases or circumstances that can worsen hypertrophic cardiomyopathy, or cause it to progress faster:
• Sleep apnea, diabetes, obesity, hypertension, rapid weight gain and hypercholesterolemia.
• Steroids, including drugs like prednisone, anabolic steroids, and testosterone can aggravate the condition. The use of growth hormones or supplements that increase growth hormone or testosterone levels may also accelerate HCM.

7. Avoid drugs that can increase your risk of having a bad event:
• Avoid stimulants and decongestants.
• Avoid alcohol consumption as its diuretic effect can lead to decreased blood volume.
• If you are on a blood-thinner (e.g., Coumadin), remember to have your blood checked monthly.

• For any abrupt new onset of neurologic symptoms, such as muscle weakness, severe headache, or change in vision, seek prompt, urgent medical attention.

8. Once diagnosed with HCM, you are restricted from competitive sports and extremes of exercise, such as avoiding heavy lifting.

9. If you are on a beta blocker for HCM, it is imperative that it is taken daily. Missing a dose results in a rebound effect that can make your heart rate increase and put you at an increased risk.

10. Enjoy life, keep active and eat healthy. Most people with HCM have a normal life expectancy.

Dr. Robert J. Tozzi is Chief of Pediatric Cardiology and the Founding Medical Director of The Gregory M. Hirsch Hypertrophic Cardiomyopathy Center at the Hackensack University Medical Center in New Jersey. He is the co-author of several papers published in refereed research journals, and he has lectured extensively in his field at numerous professional conferences. To learn more, visit his website at DRTOZ.com.
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High Cholesterol in Children: To Screen or not to Screen?

When there is a family history of early-onset coronary artery disease, or a family history of high cholesterol, the current recommendation is to screen a child for elevated cholesterol levels. In addition, screening for high cholesterol is required if a child is obese or suffering from childhood forms of hypertension or diabetes. It is currently recommended that this screening should occur between the ages of two and 10 years.

Unfortunately, these recommendations do not go far enough, and physicians risk missing many cases of significantly elevated levels of cholesterol in children.

How early should parents intervene in order to prevent potential development of coronary artery disease in their baby? The answer is that it is never too early to intervene.

A little known medical fact is that the damage caused by high cholesterol, called dyslipidemia, can begin to occur before a child’s birth, during fetal life. The diet and eating habits of the mother during pregnancy lay the groundwork for blood vessel development in the gestational fetus. After birth, the single most important and protective food a child can consume is its mother’s breast milk. Many studies have shown that breast-fed children develop far fewer chronic diseases as they grow into young adulthood, with fewer incidences of obesity, hypertension, diabetes and heart disease.

When being transitioned away from breast milk or formula, children still need a certain intake of fats, but these need to be healthy fats. Between one and two years of age, low-fat dairy foods are acceptable, and above two years of age, non-fat dairy can be introduced as part of the regular diet. When integrating eggs or meat as part of the daily menu, it is best to be assured that both poultry and cattle were raised as grain-fed livestock. A grain-based diet for these animal sources results in foods that have a higher concentration of healthy fats for the child’s intake.

To screen or not to screen may be the question of the day, but the answer to being healthy lies in what you eat. The following foods and adjustments to diet have been proven to lower serum cholesterol:

  1. Whole citrus (the pulp absorbs cholesterol)
  2. Nuts and seeds (ligands bind cholesterol)
  3. Ground flaxseed (ligands bind cholesterol)
  4. Soy protein
  5. Chick peas (hummus)
  6. Fish or fish oil 2 grams per day
  7. Dark chocolate
  8. Dark green vegetables like spinach (they are the anti-diabetes food and a good source of Omega 3)
  9. Whole grains (even instant oatmeal)
  10. Reduce the simple sugar

Eat the fruits and vegetables that stain your clothes (these tend to come from the more moderate climates like the Mediterranean region). In general, limit the fruits from the more tropical regions. Tropical fruits are healthy, but they tend to have higher free-sugar content, and if consumed to excess, they may increase the level of bad cholesterol.

Finally, do not forget the best exercise: Walking. Walking is the live-longer, anti-diabetes and lower-your-cholesterol sport for all weathers and all ages, starting in early childhood – just as soon as your toddler learns to stand on his or her own two feet.

In fact, in the healthiest cultures, there is a common proverb that sums up the basis of health living: “We have with us at all times two doctors – the right foot, and the left foot.”