David Fett

David Fett moved tons of dirt every day. But moving his body just a few feet used to leave him exhausted.

"I could barely go up a flight of stairs," says the 46-year old earth moving contractor from Fond du Lac, Wisc. "On a job site, I would have to stop walking every 50 feet or so to rest."

David was diagnosed with hypertrophic cardiomyopathy (HCM), an abnormal thickening of the heart muscle walls, in 1996. After several years of treatment at his local clinic and at another center in Wisconsin, his condition continued to worsen. He came to Mayo Clinic in 2002.

Using ultrasound imaging technology called echocardiography (similar to the ultrasound used in pregnancy), doctors at Mayo Clinic determined that the walls of the main pumping chamber of David's heart were about twice as thick as they should be. There was a particular enlargement of the muscle near the aortic valve, which blocked blood flow and also distorted the shape of the valve. That meant his heart couldn't pump efficiently, and his body was only getting about half of the normal blood supply.

"The doctors tried medications and changes to my diet, but I continued to get worse," David explains. "Whenever I would walk I became short of breath and had a tightness or aching in my chest and neck. Sometimes I got lightheaded, and before my operation it seemed like I had atrial fibrillation almost constantly."

"David is fairly typical of patients we see with severely obstructive HCM," says Steve Ommen, M.D., director of Mayo Clinic's Hypertrophic Cardiomyopathy Clinic. "Most of our patients are fairly young and some have symptoms of heart failure. About 25 percent of our patients have or develop heart rhythm problems such as atrial fibrillation, which is a rapid quivering of the heart's upper chambers that reduces pumping efficiency. For less severe cases without much obstruction of blood flow, we can often manage symptoms through medication. But for patients like David who don't respond to medication, the best solution is a surgical procedure called myectomy that involves removing the excess heart muscle wall to eliminate the obstruction."

David had his myectomy on December 3, 2003. Two days later, when he was transferred from intensive care to his regular hospital room, his nurse asked if he would like to get up and go for a walk. "I could feel the difference by the time I reached the doorway of my room," David says. "Within the first few steps I realized I wasn't getting tired like I used to. Even with a large incision in my chest, and carting along an IV pole and various tubes, I felt like I could walk and walk without getting tired."

That's what he's doing now. Each morning he gets up at 5:30 for a 45-minute walk with his dog, Ruby, a Chocolate Lab. His work, preparing large construction sites and road projects, also keeps him physically active. He recently was asked to play in a high school alumni football game. After discussing the idea with Dr. Ommen, he decided it wasn't worth the risk. "But the main thing is, I feel good enough that I could do it," David says. "There's no way I could have even considered it a few years ago."

David now knows his long-term outlook is very good, thanks to research recently published by Dr. Ommen in Journal of the American College of Cardiology. Read news release. Dr. Ommen led a team studying long-term survival in patients with severe obstructive HCM, and found that those who have surgery do much better than those who are managed through medication.

In fact, long-term survival for myectomy patients is statistically the same as for people their age in the general population. "We have seen patients like David get relief from their symptoms through surgery, and return to active lifestyles," concludes Dr. Ommen. "We didn't know whether feeling better would translate into living longer. No one can predict the future for any one patient, but now we know that overall, patients who have had a myectomy to eliminate blood flow obstruction due to HCM have the same life expectancy as people who have never had the disease."