From the Guidelines
Dizziness is a common symptom in patients with hypertrophic cardiomyopathy (HCM), often occurring in the presence of preserved systolic function and a nondilated left ventricle.
Relationship between HCM and Dizziness
- Dizziness in HCM patients is usually caused by diastolic dysfunction with impaired filling due to abnormal relaxation and increased chamber stiffness, leading to elevated left atrial and LV end-diastolic pressures 1.
- This form of diastolic heart failure may also be intertwined with other important pathophysiologic mechanisms such as myocardial ischemia, outflow obstruction associated with mitral regurgitation, and atrial fibrillation 1.
- The pathophysiology of symptoms in HCM, including dizziness, can be complex and multifactorial, involving various mechanisms such as impaired relaxation, increased stiffness, and altered energetics 1.
- Determining the cause of exercise intolerance or symptoms, including dizziness, may require invasive testing to assess diastolic dysfunction and other potential contributing factors 1.
- HCM patients often experience symptoms such as exertional dyspnea, disability, chest pain, dizziness, presyncope, and syncope, which can be related to diastolic dysfunction, myocardial ischemia, or outflow obstruction 1.
- The relationship between the magnitude of left ventricular hypertrophy (LVH) and the risk of sudden cardiac death (SCD) is complex, and while extreme LVH may convey substantial long-term risk, it is not the only factor contributing to SCD 1.
From the Research
Relationship between Hypertrophic Cardiomyopathy (HCM) and Dizziness
- HCM is a genetic disorder characterized by left ventricular hypertrophy, which can lead to various symptoms, including dizziness 2, 3.
- The exact relationship between HCM and dizziness is not explicitly stated in the provided studies, but it can be inferred that dizziness may be related to symptoms such as syncope, which is a common complication of HCM 2, 3.
- Syncope, or fainting, can be caused by obstruction to left ventricular outflow, which is a common feature of HCM 2, 4.
- Dizziness may also be related to arrhythmias, such as atrial fibrillation, which is a common complication of HCM 2, 5.
- The extent of hypertrophy is believed to be the principal determinant of the impaired left ventricular relaxation and increased chamber stiffness that characterize diastole in HCM, which may contribute to symptoms such as dizziness 4.
- Genetic testing and identification of family members at risk are important for managing HCM and preventing complications such as sudden cardiac death, which may be related to dizziness 2, 5.