Dear Doctors: I’m 68 years old and was recently diagnosed via an MRI with mild hypertrophic cardiomyopathy. Is this an unusual diagnosis at my age? I would like to know more about this condition and how it might affect doing daily tasks like lifting items or driving.

Dear Reader: Hypertrophic cardiomyopathy, also referred to as HCM, is a disease in which a portion of the muscle that forms the heart begins to grow abnormally thick. The prefix “hyper” means excessive, and “trophy” refers to growth or development. “Cardio” is drawn from the Greek word for heart, and “myopathy” indicates a disease of the muscles.

For optimum function, the heart muscle must be both strong and supple. If it becomes too thick, the bulk interferes with the heart's ability to contract and release. It's these two actions that move blood through the circulatory system. The disease can also affect the mitral valve, which separates the two chambers on the left side of the heart.

Although HCM can be caused by a range of heart and circulatory issues, in most cases it is an inherited disease. It arises due to gene variants, or mutations, that adversely affect the formation of certain protein fibers in the heart muscle. This form of HCM, which typically affects the muscular wall that separates the two lower chambers of the heart, is known as obstructive cardiomyopathy. Nonobstructive HCM is another form of the disease. It also causes abnormal growth of the heart muscle, but blood flow is not affected.

HCM can occur at any age. The disease doesn't always cause symptoms, and as a result it often goes undiagnosed. It is estimated that fewer than 15% of patients with the condition have been diagnosed. Thanks to the advent of sensitive scanning technologies such as MRI and echocardiogram, this is changing.

When symptoms do occur, they can include fatigue, shortness of breath, chest pain, skipped or fluttery heartbeats, heart murmur, atrial fibrillation, ventricular heart arrhythmia and swelling of the lower legs and feet. Some of these symptoms can be triggered by physical exertion. In some people, HCM may increase risk of heart failure or stroke.

The good news is that for many people, symptoms are minimal and do not interfere with daily life. However, it is important to arrange for your medical care provider to monitor disease progression. Treatment focuses on managing any symptoms that may occur. This often includes the use of medications, such as beta blockers, calcium channel blockers and blood thinners that affect blood flow, blood pressure and heart rate.

When drug treatment isn't effective, a minimally invasive procedure known as alcohol septal ablation may be recommended. It uses a thin tube, threaded through a vein, to deliver a small amount of alcohol to the thickened area of heart muscle. This causes some of the cells to die, which allows the remaining muscle to function properly.

Because this is often an inherited disease, it is also recommended that someone with an HCM diagnosis undergo genetic testing and, if appropriate, genetic counseling.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Hello, dear readers, and welcome back to our monthly letters column. With our inboxes still overflowing, we'll get right down to business.

-- We received a lot of letters in response to a column about fire ants and their painful bites. The mail came from all parts of the country, which shows how far these aggressive insects have spread. For managing pain from a sting, several readers swear by a first-aid device designed specifically for bug bites. It's widely available online and at big-box retail stores. "It's a suction cup that you use on each individual bite or sting to suck out the venom, reducing the effects," a reader said. "We use it on fire ant bites, and it works on mosquitoes, too!"

-- Also on the topic of fire ants, a reader from Vero Beach, Florida, was repeatedly swarmed and stung while helping her husband in their garden. "One time, I was on the concrete sidewalk, not even touching any dirt, and I had the same results," she wrote. "You need professional help to eradicate them. If you just get them to move out of your yard, you're sending them to your neighbors. Fire ants are swift, invasive and dangerous. You can be bitten before you ever see them." Her advice echoes that of several other readers, who say they needed professional intervention to make their yards safe for children, pets and themselves.

-- A reader who wants to follow the advice to take a brisk walk every day wonders what that entails. "I am 80 years old and walk twice a day for 20 to 30 minutes," they wrote. "The advice I hear almost always says to walk briskly. But how fast is brisk?" While brisk sounds as though it has to do with speed, the goal is actually a specific level of exertion. This can be evaluated by breath capacity. A brisk pace means you can manage the short sentences of a chat, but the sustained outflow of breath needed for singing would not be possible. When the pace needed for a brisk walk isn't possible due to physical limitations, carrying light weights, adding arm movements or choosing a path with a slight incline can increase intensity. It's wise to check with your health care provider about any changes you plan to make to your existing exercise routine.

-- A column that referenced a pill-based colonoscopy prep also got a lot of mail. "Is it true there's a colonoscopy prep pill?" a reader asked. "FDA approved?" The answer to both questions is yes. The FDA approved the first tablet for colonoscopy prep in November 2020. Known as SUTAB, it's an alternative for some people who can't use liquid colonoscopy prep solutions. It's not right for everyone, and it can have side effects. Your doctor can advise you if it may be an option.

Thank you, as always, for your letters. We love hearing your thoughts, are grateful for your kind words and are thrilled to know these columns engage you, and even help.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: Would you please address radon gas? I've spent 40 years in real estate sales here in Florida, and while radon is noted in inspections, most buyers don't realize it's dangerous. Any information about the health risks, and how to protect yourself, could help a lot of people.

Dear Reader: Thank you for bringing up an important topic. You're correct that radon is not well recognized as a potential health threat. And yet, according to the U.S. Environmental Protection Agency, it's a leading cause of lung cancer in this country, second only to smoking.

Radon is a clear and colorless radioactive gas. It forms as the radioactive particles that are present in virtually every type of soil, rock and groundwater go through a slow and complex process of decay. Over time, long-term or repeated exposure is linked to an increased risk of lung cancer.

Radon gas can be present in any structure of any age, and in any region. The primary entry point is via cracks and fissures in a building’s foundation. Buildings with basements, which sit below ground level, are more likely to be affected by radon. This is due to their proximity to the soil and porous building materials, which make it easier for the gas to enter.

The pressure differential between the inside and outside of the home also plays a role. The lower pressure indoors acts like a vacuum and draws radon into the house. Natural air currents, plus heating and cooling systems, further disperse the gas.

When you breathe, radon gas in the environment enters the lungs. Radioactive particles, which emit low-level energy as they decay, can get trapped in the tissues. Over time, these bursts of energy can cause the cellular changes that lead to lung cancer.

The risk of cancer is higher for people who smoke. Data show that a smoker who is regularly exposed to radon in the environment has up to 10 times the risk of developing lung cancer than a nonsmoker who undergoes the same level of exposure.

For most of us, the most likely site of radon exposure is our home. Fortunately, simple and affordable detection tests are available online and from home-improvement and hardware stores. The test is put into place for either a few days or a few months and then mailed to a lab for analysis. The EPA recommends testing the basement, first floor and second floor of all homes. This includes newly built and so-called radon-resistant homes.

When radon is found, mitigation is necessary. Your state radon office or the EPA can provide information about qualified specialists to remove existing radon and put reduction measures in place. Even with radon-reduction systems, homes should be tested every two years, no matter their age. It's also helpful to increase air circulation in the home, and to seal any cracks in the floors or walls. The EPA website has a library of useful information about radon gas prevention and mitigation. Go to epa.gov and type “radon” into the search box at the top of the page.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)