Hypertrophic cardiomyopathy activities and circumstances to avoid

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Editors-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Any activity, drug or circumstance that increases left ventricular outflow obstruction, reduced left ventricular filling, or increases left ventricular afterload should be avoided.

Activities That Increase Left Ventricular Outflow Tract Obstruction

Activities That Reduce Preload

The following activities increase left ventricular outflow tract obstruction and should be avoided^[1]^[2]:

Nausea and vomiting
Dehydration
Hypovolemia (i.e., use diuretics with caution)
Medications that reduce preload and left ventricular filling such as nitrates
Alcohol ingestion may change outflow obstruction for a wide variety of reasons ^[3]
Heavy meals may change the outflow obstruction for a wide variety of reasons including splanchnic pulling of blood

Activities That Increase Afterload

The following activities increase left ventricular afterload should be avoided:

Competitive endurance training
Burst activities (e.g., sprinting)
Intense isometric exercise (e.g., heavy weight lifting)

References

↑ Braunwald E, Lambrew C, Rockoff D et al. Idiopathic hypertrophicsubaortic stenosis. I. a description of the disease based upon an analysis of 64 patients. Circulation 1964;30(Suppl IV):3–217.
↑ Kizilbash AM, Heinle SK, Grayburn PA. Spontaneous variability of left ventricular outflow tract gradient in hypertrophic obstructive cardiomyopathy. Circulation 1998;97:461–6.
↑ Paz R, Jortner R, Tunick PA et al. The effect of the ingestion of ethanol on obstruction of the left ventricular outflow tract in hypertrophic cardiomyopathy. N Engl J Med 1996;335:938–41.

[1] Braunwald E, Lambrew C, Rockoff D et al. Idiopathic hypertrophicsubaortic stenosis. I. a description of the disease based upon an analysis of 64 patients. Circulation 1964;30(Suppl IV):3–217.

[2] Kizilbash AM, Heinle SK, Grayburn PA. Spontaneous variability of left ventricular outflow tract gradient in hypertrophic obstructive cardiomyopathy. Circulation 1998;97:461–6.

[3] Paz R, Jortner R, Tunick PA et al. The effect of the ingestion of ethanol on obstruction of the left ventricular outflow tract in hypertrophic cardiomyopathy. N Engl J Med 1996;335:938–41.

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