DEAR DR. DONOHUE: My husband’s twin died unexpectedly and suddenly one month ago. He was 39. He had no signs of illness. He was physically fit, as he worked hard in the construction business. An autopsy showed he had hypertrophic cardiomyopathy. All his children are being examined for it, and my husband was advised to be examined too. We are in need of information on this subject. Would you provide some for us? – P.G.

“Hypertrophy” means overgrowth. Hypertrophic cardiomyopathy is heart enlargement due to an overgrowth of heart muscle. You might think that would be a good thing. Here it isn’t. The heart muscle fibers are laid down haphazardly, and the huge bulk of muscle can obstruct blood flow out of the heart. This is a genetic condition. That’s why your nieces, nephews and your husband have been advised to be examined for it.

There are many variations of hypertrophic cardiomyopathy. I have to choose one as a prototype, so what I say isn’t applicable to everyone with the condition.

Symptoms common to hypertrophic cardiomyopathy, when they arise (they don’t always), include breathlessness when a person engages in even a slight amount of physical exertion, fainting episodes, fatigue, palpitations and heart failure. In addition to the obstruction of blood flow out of the heart, hypertrophic cardiomyopathy can generate unusual heartbeats, some so unusual that they can be fatal. It’s one of the causes of sudden death in young people like your brother-in-law.

Echocardiograms – soundwave pictures of the heart – clearly reveal the changes of cardiomyopathy. I’m sure that your husband and your nephews and nieces will have echocardiograms. If it turns out any of them has the condition, then its seriousness has to be evaluated so preventive measures can be taken.

Sometimes medicines are the necessary prevention. At other times, an implantable defibrillator (a device somewhat like a pacemaker) has to be installed to stave off potentially dangerous heart rhythms. And sometimes surgical removal of excess heart muscle is the treatment. Heart muscle can also be pared away by injecting alcohol into a heart artery to cause selective death of parts of the enlarged muscle.

DEAR DR. DONOHUE: Several times a month I get bad headaches and become sick to my stomach. I have mentioned this to my doctor, but he can’t give me an answer. I am under treatment for blood pressure. Can you suggest anything? – C.B.

A pheochromocytoma (FEE-oh-CROW-moe-sigh-TOE-mah) could explain your symptoms. It’s a tumor of the adrenal gland. Adrenaline is one of the hormones this tumor makes. Release of adrenaline raises blood pressure and often produces headache, sweating, nausea and dizziness. Sometimes there is facial flushing.

The high blood pressure is often sustained while the other symptoms occur periodically.

The diagnosis is made by finding in the urine the hormone products of a pheochromocytoma.

Admittedly this isn’t a common condition. It accounts for about 0.1 percent of all high blood pressure cases. But with someone having the symptoms you have, it’s worth considering.

DEAR DR. DONOHUE: My husband tells me I grind my teeth at night. I am not aware of it, and my teeth look normal to me. Aside from the fact that I am ruining my husband’s sleep, does this need any attention? – D.S.

Bruxism, as teeth-grinding is called, needs attention if you don’t want to wear your teeth down to stubs. The causes of it are many. Stress, often unrecognized, can make it happen. The jaw joint might be out of line. A cause should be found, if possible, and treated. Your teeth need protection. You can get tooth guards in drugstores or sports stores, but ones specifically fashioned for your teeth by a dentist are more comfortable and better tolerated. You might also try putting warm packs on your cheek and jaw muscles before retiring, to relax them.

Let your dentist know what’s going on.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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