HCM Patient Returns to Hiking the Appalachian Trail

Stuart O. Smith, Jr., is a retired website director and experienced backpacker. Now in his mid-sixties, Stuart is a former Appalachian Trail thru-hiker and has been section hiking the Appalachian Trail for 10 years in the hope of completing the entire trail a second time. In early 2023, this man, who hiked mountains, suddenly couldn’t walk up two steps without feeling winded.

Stuart was diagnosed with hypertrophic cardiomyopathy (HCM), a condition affecting the left ventricle (the main pumping chamber) of the heart. In people with HCM, the walls of the left ventricle become thick and stiff. Over time, the pressures in the heart rise. In Stuart’s case, the thickened heart muscle was also intermittently blocking blood flow out to the body.

Symptoms of HCM can include gasping for air, lightheadedness or weakness, and the feeling of a heavy chest or chest pain.

People with HCM may need to make lifestyle changes, such as limiting their activity to adjust for their disease. As the disease progresses, it can cause other health problems. People with HCM are at higher risk for developing atrial fibrillation, which can lead to blood clots, stroke and other heart-related complications. HCM may also lead to life-threatening heart failure.

“I had to quit hiking, which was devastating,” said Stuart.

But soon he regained hope, thanks to his caregivers at University Hospitals Harrington Heart & Vascular Institute. Stuart and his cardiologist, Eiran Gorodeski, MD, MPH, developed a plan.

“I did a lot of research on my own, as well as discussed options with my doctors,” he said. “I knew that the success rate was high with the option I ultimately chose.”

In April of 2023, Stuart underwent open-heart surgery at UH Cleveland Medical Center to address his HCM.

“Stuart’s surgery went very well. We performed a procedure known as septal myectomy where a portion of the overgrown and thickened muscle that is causing obstruction was removed. Stuart’s surgery was uneventful, and he made an excellent recovery,” said Stuart’s cardiothoracic surgeon, Dr. Yasir Abu-Omar, Surgical Director of the Advanced Heart Failure & Transplant Center, and Russ and Connie Lincoln Chair in Cardiovascular Innovation at UH Harrington Heart & Vascular Institute.

“The first day I got home from the hospital, I walked just under a mile. And the second day home from the hospital, I walked just under a mile,” he said.

“Many of his symptoms disappeared,” said Dr. Gorodeski. “The trophy on the top was that he was able to go back to hiking, which honestly, I wasn't sure he was ever going to be able to do. We always hope for the best outcome for our patients, but Stuart exceeded our expectations, which is just wonderful.”

Just two months after his surgery, Stuart was back to day hiking sections of the Buckeye Trail to rebuild his strength. This led to him being able to take a 54-mile backpacking trip on the Appalachian Trail in Massachusetts just five months after his open-heart surgery.

“My endurance returned to how it was previously, like I’d never experienced the surgery or a heart condition,” Stuart said.

Today, Stuart has no HCM symptoms. He says his stamina and strength are great. He’s back to normal, living his life to the fullest.