One of the most common cardiac abnormalities found in medical examinations these days is “thickening of the heart.” So, what should you suspect, and how should you deal with it when you receive a test result that says your heart is thickened?

Professor Lee Sang-chol of the Department of Cardiology at Samsung Medical Center explained that “cardiac hypertrophy” and “myocardial hypertrophy” are medical test results related to an increase in the thickness of the wall of the heart muscle that pumps blood, according to the Korean Society of Echocardiography's YouTube channel “SEchoTV.”

Currently, there are two types of heart muscle thickening -- those with a clear cause and those without a clear cause. So, what are the most common causes of heart muscle thickening?

“The most common is high blood pressure for a long period,” Professor Lee said. “Or, if there is a problem with the aortic valve and there is a narrowing, the heart reacts, and the muscle becomes thicker.”

Rare diseases should also be suspected when the heart muscle thickens.

“In a condition called hypertrophic cardiomyopathy, the heart muscle thickens spontaneously due to some genetic factor,” Professor Lee explained. “It is the most common cause of sudden cardiac death in young people.”

In addition to being a cause of sudden cardiac death, hypertrophic cardiomyopathy is a rare disease that deserves some attention.

“Its prevalence has been increasing rapidly in recent years, and it is estimated that there are many cases that have not yet been detected in Korea,” Professor Lee said.

So, what should you do if a medical examination shows that you have a thickened heart through an electrocardiogram or echocardiogram? According to Lee, the first step is to see a doctor who specializes in cardiology and then repeat the echocardiogram.

“If you have an enlarged heart, it can be divided into cardiomegaly, which is the overall enlargement of the heart, and myocardial hypertrophy, which is the thickening of the heart muscle,” Lee said. “In either case, an echocardiogram, which is a direct, simple, and detailed examination of the heart, is needed to determine if the heart is enlarged or if the heart muscle is thicker.”

Even if you've already had an echocardiogram as part of your annual checkup, there are reasons to repeat it under the care of a cardiologist.

“A screening echocardiogram is incomplete, so a detailed echocardiogram checks things like heart wall thickness and heart size in more detail,” said Professor Lee Hyun-jung of the Department of Cardiology at Severance Hospital.

In addition to an echocardiogram, a cardiac CT scan or cardiac MRI may be required.

“In medical examinations, changes in the ECG can be caused by thickening of the heart muscle, but they can also be caused by problems with the heart's blood vessels,” Professor Lee Hyun-jung noted. “Cardiac CT is a useful test when a patient has symptoms, such as chest pain or shortness of breath, and the coronary arteries need to be checked together.”

Cardiac MRI is also necessary when hypertrophic cardiomyopathy is suspected.

“In cases such as hypertrophic cardiomyopathy, where the myocardium is thickened, if the heart muscle itself is degenerating, we need to see fibrosis and some necrosis in the heart muscle, so we also perform cardiac MRI tests,” Professor Lee Sang-chol said.

So, if you've gone through this process and been diagnosed with hypertrophic cardiomyopathy, what kind of treatment do you need?

“If you have hypertrophic cardiomyopathy, it can cause sudden cardiac death, so when you first come in, we first determine if you have a high risk of sudden cardiac death. If it is high, we recommend inserting a device such as a defibrillator to prevent sudden death,” Professor Lee Hyun-jung said.

Besides, thicker heart muscle can narrow the left ventricular outflow tract, the way blood flows out of the heart when it contracts, which can put pressure on it and require additional measures.

“In such cases, new drugs reduce the pressure,” Professor Lee Hyun-jung said. “We also consider surgery to cut out the thickened heart muscle to allow blood to flow smoothly.”

In addition to left ventricular outflow tract stenosis, there are cases in which the heart function gradually decreases due to thicker heart walls, which also requires additional treatment.

“In such cases, medication is used to treat the decline in heart function,” Professor Lee Hyun-jung said. “Later, if the condition becomes more severe, heart transplantation is considered.”

While your heart may be thickened, a rare condition called “hypertrophic cardiomyopathy,” which is associated with a high risk of sudden death, you don't need to worry too much if your heart is enlarged.

“In many cases, there are suspicious findings without cardiac enlargement or myocardial hypertrophy, so you shouldn't worry too much,” Professor Lee Sang-chol said.