Abstract 1393: Emotional Stress Triggers Symptoms in Individuals With Hypertrophic Cardiomyopathy: A Survey of the Hypertrophic Cardiomyopathy Association (HCMA)
Introduction: Symptoms are the most important factors impacting quality of life (QOL) in hypertrophic cardiomyopathy (HCM) patients, and reflect a poor prognosis. Whether emotional stress can trigger symptoms of chest-pain, dyspnea, palpitations, and lightheadedness in HCM patients is unknown.
Methods: Members of the HCMA received an electronic link via e-mail to an ongoing online survey, which could also be accessed via links on the HCMA message-board and homepage, starting in 5/07. By 11/08, there were 1297 respondents.
Results: Respondents were 58% male, median age 44 years (iqr 33–55). Symptoms reported included chest-pain (49%), dyspnea (70%), palpitations (61%), and syncope or lightheadedness (59%). Forty percent of respondents described experiencing symptoms when under emotional stress, and 64% while climbing stairs or hills. Those reporting chest-pain were more likely to report emotion-triggering (60%) than those reporting palpitations, syncope/lightheadedness or dyspnea (50 –54% each). Both physical and emotional quality of life were significantly decreased in those describing emotion-related symptoms, while only physical QOL was decreased in those with exertion-related symptoms. Emotion-triggered symptoms were more common in women, and those with atrial fibrillation (N=302) or an ICD (N=303), even after controlling for overall experience of symptoms (see figure⇓).
Conclusions: Triggering of symptoms by emotion is common in individuals with HCM. Further studies will determine pathways linking emotional stressors with chest-pain, dyspnea, palpitations, and lightheadedness in these patients.