DEAR DR. DONOHUE: I am 25 and the oldest of five boys. All of us have been active in sports. My 14-year-old brother had an examination to play football. The doctor heard a murmur and had further tests done, including an echocardiogram (soundwave picture of the heart). It turns out my brother has something called hypertrophic cardiomyopathy. My mother called to tell me that all of us need to be examined for it. Why? I had many exams previously. — C.J.

ANSWER: “Hypertrophic” means the heart has become overgrown. “Cardiomyopathy” indicates that the heart enlargement isn’t the result of high blood pressure, heart valve disease or clogged heart arteries. Here, the cause is genes. It’s an inherited condition. That’s the reason why you and your brothers need an examination. Even if you have never heard of this condition, it isn’t uncommon. It’s found in as many as one in 500 people randomly examined off the street. Most of these people have no symptoms, but they are likely to develop them.

Others come down with symptoms at earlier ages. Fainting spells, an indication of abnormal heart rhythms, are a common sign. (Most fainting spells are quite innocent and NOT related to this disorder.) Breathlessness on slight exertion is another sign. An examining doctor can heart a murmur typical of the disorder. You could have the problem without having a murmur, so it wasn’t discovered. An echocardiogram provides evidence that clinches the diagnosis.

Sudden death in a young athlete often is caused by hypertrophic cardiomyopathy. Not only has the heart muscle grown larger, but it has been laid down in a careless manner, and it generates dangerous heart rhythms.

Treatment depends on the extent of the process. Some cases can be controlled with medicines. For others, paring away excess heart muscle is the way to correct the problem. Injecting alcohol into the most overgrown areas of the heart can reduce its size. Surgery is another option. In some cases, a defibrillator is implanted to prevent sudden death from abnormal heart rhythms.

DEAR DR. DONOHUE: What causes snoring? My husband keeps the entire family awake because of his snoring. Does it indicate an illness? Our children laugh about it, but I don’t find it the least bit amusing. — R.G.

ANSWER: A vibrating reed makes the sound produced by any wind instrument. A snore comes from vibration of redundant throat tissue. Obesity, therefore, is one cause of snoring. Obesity-caused snoring can be cured or diminished by weight loss.

Alcohol or similar relaxants also encourage snoring. They cause such relaxation of throat tissues that they vibrate just like the excess tissues of an obese individual. Taking no alcohol from dinnertime on will reduce the volume of the nocturnal symphony.

If your husband has pauses in his snoring, he could be suffering from sleep apnea, a medical condition that requires treatment.

For ordinary snoring, sleeping on one’s side can put an end to it. People do not stay on their sides through the entire night. If you make a pocket in the back of the pajamas and put a tennis ball in it, that will keep your husband on his side.

Your family’s dentist can fit your husband with a device that draws the lower jaw forward. It opens the throat and prevents snoring.

DEAR DR. DONOHUE: My mother made all her children chew their food at least 25 times. She claimed that it helped food digest. I gave this up when I left home at 18. Is there any evidence that chewing that number of times aids digestion? — H.H.

ANSWER: The object of chewing is to reduce the size of food so it can be swallowed easily and to mix saliva with the food for the same reason. Saliva starts the digestive process.

I have never heard that a prescribed number of chews is necessary to accomplish these goals.

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 www.rbmamall.com.

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