What to Expect From a New Obstructive Hypertrophic Cardiomyopathy Treatment Plan

Starting a new medication for obstructive hypertrophic cardiomyopathy (oHCM) often means more appointments and testing. But that extra monitoring exists for a reason: It helps your care team find the right dose and ensures your heart is responding safely.

“These medications are a little bit more nuanced and require a little bit more frequent follow-up,” says Jessica Lauren Atkins, MD, a cardiologist specializing in hypertrophic cardiomyopathy at Medical University of South Carolina Health in Charleston.

Once you know what’s coming, though, the schedule tends to feel a lot less daunting.

“We can look at the heart squeeze. We can evaluate all the valves. And then we can also identify if there’s any level of obstruction or abnormal muscle thickening that’s blocking the blood flow moving through the heart,” says Dr. Atkins.

Your doctor may also want to schedule an EKG (electrocardiogram) to check your heart’s electrical activity or send you home with a Holter monitor to track your heart rhythm over the course of a few days, she says.

The medication dose may need to be adjusted, or titrated, over time. Your care team will track symptoms and your echocardiogram results to decide whether the current dose is working well or needs a change.

Overall, Atkins says people starting these medications are “often coming in about every month or so for the first few months of therapy” until test results stabilize and breathing improves.

At these visits, expect a symptom check and another echocardiogram. Your care team will be monitoring your heart to see if it’s less obstructed and strong enough that it’s pumping effectively.

Once the dose is stable, your appointments will ease up, requiring follow-ups every three to six months, says Atkins.

Symptoms matter just as much as lab results, so watch for any change in what you’re able to do, says Atkins. “Anything that is not getting better is something that we should pay attention to,” she says. And call your care team right away if you notice new shortness of breath, lightheadedness, fainting, or dizziness or a racing heartbeat.

The following strategies can make your medical schedule easier to manage:

• Batch your visits. Ask if your echocardiogram and cardiology check-in can happen the same day.
• Set reminders. Put echocardiogram dates, prescription refills, and clinic visits on your phone calendar.
• Give your workplace a heads-up. Let your employer know early that you’ll need some flexibility over the next few months.
• Keep a symptom log. Jot down what you do each day and which tasks feel as if they’re getting harder to do, says Atkins.

And don’t be afraid to ask questions. Before starting any new medication, Atkins says she and her team walk her patients through “the benefits, the risks, side effects, and the follow-up that’s necessary.”