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Hypertrophic Cardiomyopathy - Exercise Recommendations


Updated July 29, 2009

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Hypertrophic cardiomyopathy (HCM) is one of the cardiac conditions associated with sudden death in young athletes. In fact, it is one of the more common genetic cardiac disorders. In the United States, it accounts for 36% of sudden deaths in young athletes. African Americans account for more than 50% the sudden deaths during exercise seen with HCM.

Those with HCM aren't banned from all activities, though they are restricted. It's important to know what the limits are to stay safe.

What Exactly Is Hypertrophic Cardiomyopathy?

HCM is characterized by an abnormal thickening of the heart muscle, a condition called hypertrophy. The hypertrophy can cause an excessive "stiffness" in the left ventricle of the heart, a partial obstruction to blood flow within the left ventricle, or abnormal function of the mitral valve. All of these features of HCM can lead to heart failure.

The abnormal thickening of the heart muscle can make some patients prone to develop dangerous ventricular arrhythmias and sudden death. These arrhythmias are often most likely to occur during vigorous exercise.

What Are the General Exercise Recommendations For Young Athletes With HCM?

According to the 2005 36th Bethesda Conference on Eligibility Recommendations for Competitive Athletes with Cardiovascular Abnormalities, athletes who have HCM should not participate in most competitive sports, with the possible exception of low intensity sports (such as bowling or golf).

Those with HCM who aren't on an organized team but do engage in sports from time to time should also avoid most high-intensity sports such as hockey, basketball, and singles tennis. Some moderate-intensity and most low-intensity sports can be enjoyed in moderation. These include golf, doubles tennis, swimming laps and skating.


Maron, BJ, Ackerman, MJ, Nishimura, RA, et al. Task Force 4: HCM and other cardiomyopathies, mitral valve prolapse, myocarditis, and Marfan syndrome. J Am Coll Cardiol 2005; 45:1340.

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