Is Exercise Safe With Hypertrophic Cardiomyopathy? What Doctors Say

Experts generally advise exercise for heart health, but hypertrophic cardiomyopathy (HCM) makes the situation more complicated. People with hypertrophic cardiomyopathy, a hereditary disorder that causes the heart muscle to swell, have been given conflicting workout recommendations over the years.

Due to worries about abrupt cardiac mortality, doctors may have previously advised against physical exertion. However, new guidelines show a change in perspective.

They clarify that exercise is not only beneficial and vital, but that individuals with the illness, when adequately supervised, may even participate in sports at the highest levels safely.

The updated guidelines, in the American Heart Association journal Circulation, affirm that mild and moderate-intensity recreational exercise is good for people with hypertrophic cardiomyopathy, said Dr. Steve Ommen, medical director of the Mayo Hypertrophic Cardiomyopathy Clinic in Rochester, Minnesota.

In this article, we’ll examine possible hazards, dissect the opinions of medical professionals regarding the safety of exercise with HCM, and provide helpful advice to keep you moving safely.

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Understanding Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) causes the heart muscle to thicken, or become hypertrophied. The thicker heart muscle may hamper the heart’s ability to pump blood.

Many individuals with hypertrophic cardiomyopathy are unaware that they have the condition. It is because their symptoms are minimal, if they exist at all. However, the thicker heart muscle can produce severe symptoms in a tiny percentage of HCM patients. These consist of chest discomfort and dyspnea.

In certain HCM patients, changes in the heart’s electrical system can trigger sudden death or potentially fatal irregular heartbeats.

Yes, mild intensity activity is generally safe, says cardiologist Maran Thamilarasan, MD. And, in fact, it’s recommended.

“Historically, you’d hear these stories of young athletes dying suddenly with undiagnosed hypertrophic cardiomyopathy,” shares Dr. Thamilarasan. “The thought was that we should significantly restrict activity. That was the dogma for many years. But now, we recognize that each individual is different and it’s essential to maintain some level of physical activity, both for someone’s mental well-being and their physical fitness.”

Exercise Risks in HCM: Why Caution Matters

Before starting any fitness program, especially if you wish to be more active, Dr. Thamilarasan emphasizes the value of undergoing a risk assessment. By doing this, you can assess your risk of experiencing an arrhythmic episode, or irregular heartbeat, during your workout.

It is difficult to overlook the numerous cardiovascular advantages of exercise. Studies show that exercise strengthens the heart muscle and helps prevent weight gain and artery damage caused by high blood pressure, cholesterol, and blood sugar — all factors that contribute to heart attacks or strokes. Exercise decreases stress as well as the feelings of sadness and anxiety that contribute to heart problems.

“We’ve always known that people who exercise regularly have far less of a risk of having heart disease and early mortality than those who don’t,” says Kerry J. Stewart, Ed.D., a professor of medicine at Johns Hopkins School of Medicine in Baltimore, MD, and the director of its clinical and research exercise physiology programs.

However, if you or a close family member has been diagnosed with HCM, you shouldn’t be hesitant to seek a physical. The primary hereditary disorder reduces blood flow to the rest of the body by thickening and stiffening portions of the heart muscle. About one in 500 persons (approximately 700,000 in the United States) is impacted by HCM. This condition can be asymptomatic; however, a considerable number of cases go misdiagnosed.

“People with HCM can have many separate but related cardiac abnormalities that may be exacerbated by exercise,” explains Kathryn Larson, M.D., a non-invasive cardiologist and an assistant professor of medicine at the Mayo Clinic College of Medicine and Science in Rochester, MN.

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Types of Exercise: What’s Safer, What’s Risky

The American Heart Association’s most recent recommendations call for mild to moderately intense exercise, such as:

• Biking and Walking
• Swimming while a lifeguard is present (if the assessment does not indicate a danger of fainting)
• Aqua aerobics
• Dancing (social or ballroom)
• Medium-paced elliptical trainer
• Doubles tennis or pickleball

“Almost all people with hypertrophic cardiomyopathy can engage in such activity to maintain cardiovascular fitness,” says Dr. Thamilarasan. “If you have low markers of risk, then it may be possible to engage in a higher level of activity.”

Accordingly, the majority of persons with HCM can meet the recommended weekly intake of 150 minutes of mild-intensity aerobic activity. Dr. Thamilarasan says it’s not unrealistic to aim for 30 to 60 minutes of aerobic activity each day.

Based on your risk assessment, your doctor will inform you of any exercise limits related to hypertrophic cardiomyopathy.

“If you’re at high risk for arrhythmic events and you have significant obstruction, then we may recommend low-intensity exercise,” says Dr. Thamilarasan.

That could mean avoiding high-intensity training, such as HIIT or heavy resistance training. However, you can still focus on low-intensity exercises like yoga, Pilates, light stretching, or dog walking.

Warning Signs to Stop Exercise Immediately

Listening to your body is crucial when you have hypertrophic cardiomyopathy (HCM). When done correctly, exercise can be safe, but it’s just as essential to know when to quit as it is to know when to start. You should never disregard any warning signs because they could be an indication that your heart is under stress.

• Chest discomfort
• Dizziness
• Lightheadedness
• Heart palpitations
• Breathlessness

Keep an eye out for anything that causes you to feel more breathless than is appropriate for the exercise level. Don’t try to force it. You must pay attention to the warning indicators.

In general, there is no universally applicable advice regarding exercise for people with hypertrophic cardiomyopathy. Since every person is different and has a different set of circumstances, see your doctor to find the best kind and level of exercise for you.

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Living Actively With HCM: Practical Tips

Patients with hypertrophic cardiomyopathy (HCM) can take a significant part in their own care by maintaining a healthy lifestyle, exercising, and abstaining from behaviors that could worsen their condition. Your heart compensates for a stiff and sluggish muscle in direct correlation with your overall fitness level, so it’s critical to:

• Engage in a regular physical activity at a level prescribed by your doctor. Moderate walking and bicycling can improve your endurance and enhance your overall well-being.
• Steer clear of competitive sports, weightlifting, and severe bursts of exercise.
• When doing housework, avoid lifting large objects.
• Steer clear of extreme temperatures like cold or heat.
• Eat a heart-healthy diet.
• Keep an eye out for indications of infection from any cuts or scratches.
• Discover how to reduce stress by using relaxation techniques, biofeedback, or meditation.
• Before consuming alcohol or caffeine, speak with your doctor.
• Avoid using over-the-counter cold remedies and diet tablets.
• Steer clear of saunas and hot tubs.
• To keep an eye on your condition, make sure to schedule routine visits with your cardiologist.

Read More:  Heart Health in Your 30s: 8 Habits That Can Protect You for Life

Conclusion

Movement and exercise are essential for overall health, but for an individual with hypertrophic cardiomyopathy (HCM), the type and intensity of exercise are far more critical than the volume. With HCM, you only need to choose your workouts more selectively and thoughtfully; you do not need to abandon exercise.

Activities that are typically safe and beneficial for an individual with HCM to maintain strength, enhance cardiac health, and promote overall wellness include light to moderate activities such as walking, swimming, cycling, and yoga. Generally, a person with HCM should avoid heavy lifting, intense training, or competitive sports due to the increased load on the heart, which might result in greater risks.