Heart-Healthy Eating When You Have Obstructive Hypertrophic Cardiomyopathy

While obstructive hypertrophic cardiomyopathy (oHCM) is a structural heart issue, what you eat and drink can affect how that structure functions — and how you feel as you go about your daily activities, both now and in the future.

The right diet won’t change your condition, but in many cases, it may make your symptoms more manageable, says Jessica Atkins, MD, the medical director of the Hypertrophic Cardiomyopathy Clinic at the Medical University of South Carolina in Charleston.

Here are expert-recommended tips that can make a difference.

“Staying well hydrated will help to maintain proper blood volume in the heart and prevent drops in blood pressure, which can lead to dizziness or fainting,” says Bethany Barney, RD, a certified clinical transplant dietitian with the University of Rochester Medicine’s Advanced Heart Failure Program in New York.

Barney encourages her oHCM patients to drink at least 8 cups of water daily, though you may need more based on things like the weather and your activity level. “Some foods, like fruits, vegetables, low sodium soup, and gelatin can also be good sources of fluid,” she says.

You should try to stay below the recommended limit of 2,300 milligrams (mg) of sodium per day, but don’t aim for a super low sodium diet unless you’ve been instructed to do so by your care team.

“Too much sodium can increase blood pressure and fluid retention, potentially worsening shortness of breath or heart strain,” says Behram Mody, MD, the director of the hypertrophic cardiomyopathy program at UCI Health in Orange, California. But “too little sodium, especially combined with dehydration, can reduce blood volume and worsen outflow obstruction, leading to dizziness or fainting.”

One of the best ways to keep your salt intake in check: Limit the amount of processed and packaged food you eat. Processed meats and cheeses, boxed noodle or rice dishes, canned soups, frozen dinners, and extra condiments or sauces are some of the most common offenders, Barney says.

Some people with oHCM notice that their symptoms worsen after a big meal. “Larger meals can redirect blood flow to the digestive system, reducing blood volume returning to the heart and increasing baseline heart rate,” explains Dr. Atkins. Those things can temporarily worsen your obstruction as blood tries to move through the chambers of your heart — leading to more heart palpitations, chest pain, or shortness of breath.

This definitely isn’t the case for everyone, Atkins adds. But if you find that you’re more comfortable with lighter portions, consider experimenting with smaller, more frequent mini-meals rather than three big squares.

And if exercise is a struggle because of your oHCM symptoms, know that small amounts of activity really can add up — and improve your fitness over time. “You don’t have to go to the gym for hours each day,” Atkins says. “Start with 10-minute walks every day and slowly increase this by 3 to 5 minutes each week until you’re walking for 30 minutes.”

• Hydration is essential for managing oHCM symptoms; sufficient fluid intake maintains blood volume and prevents drops in blood pressure that can lead to dizziness, fainting, or increased heart strain.
• Balance your sodium intake; too much sodium can raise blood pressure and fluid retention, while too little can reduce blood volume and worsen symptoms.
• Smaller, more frequent meals and a heart-healthy diet (like Mediterranean or DASH) may reduce symptoms and ease strain on the heart.
• Lifestyle habits like maintaining a healthy weight and limiting stimulants can minimize symptoms and lower the risk of complications.