Hypertrophic cardiomyopathy: Difference between revisions

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'''Hypertrophic cardiomyopathy''' (<abbr>HCM</abbr>) is a form of [[cardiomyopathy]] characterised by left ventricular hypertrophy in the absence of a provoking disease like [[hypertension]] or [[aortic stenosis]]. The hypertrophy is often asymmetric.
<section begin="radiology" />'''Hypertrophic cardiomyopathy''' (<abbr>HCM</abbr>) is a form of [[cardiomyopathy]] characterised by left ventricular hypertrophy in the absence of a provoking disease like [[hypertension]] or [[aortic stenosis]]. The hypertrophy is often asymmetric.


'''Hypertrophic obstructive cardiomyopathy''' (HOCM) is a subtype of HCM characterised by obstruction of the left ventricular outflow tract due to excessive hypertrophy of the ventricular septum.
'''Hypertrophic obstructive cardiomyopathy''' (HOCM) is a subtype of HCM characterised by obstruction of the left ventricular outflow tract due to excessive hypertrophy of the ventricular septum.<section end="radiology" />


It’s a common cause of [[sudden cardiac death]], especially in athletes. It may also progress into left ventricular dilation. It’s the second most common CMP, affecting 1/500.
It’s a common cause of [[sudden cardiac death]], especially in athletes. It may also progress into left ventricular dilation. It’s the second most common CMP, affecting 1/500.
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For some affected people, [[sudden cardiac death]] is the first manifestation of HCM.
For some affected people, [[sudden cardiac death]] is the first manifestation of HCM.
 
<section begin="radiology" />
== Diagnosis and evaluation ==
== Diagnosis and evaluation ==
[[Echocardiography|ECG]] shows signs of left ventricular hypertrophy and strain. [[Echocardiography]] shows left ventricular hypertrophy, a septum which is thicker than the posterior wall, normal LV chamber size. SAM may also be visualised.
[[Echocardiography|ECG]] shows signs of left ventricular hypertrophy and strain. [[Echocardiography]] shows left ventricular hypertrophy, a septum which is thicker than the posterior wall, normal LV chamber size. SAM may also be visualised.


[[Magnetic resonance imaging|MRI]] is the gold standard for the evaluation. 1st degree relatives should be screened for the condition.
[[Magnetic resonance imaging|MRI]] is the gold standard for the evaluation. 1st degree relatives should be screened for the condition.
 
<section end="radiology" />
== Treatment ==
== Treatment ==
There’s no specific treatment. Strenuous physical activity should be avoided to prevent [[sudden cardiac death]]. In case of significant LVOT obstruction, medical treatment is indicated, but it’s not certain whether medical treatment is indicated for HCM without significant LVOT obstruction. Medical treatment includes [[Beta blocker|beta blockers]], [[Calcium channel blocker|CCBs]], and [[Antiarrhythmic drug|antiarrhythmic drugs]].
There’s no specific treatment. Strenuous physical activity should be avoided to prevent [[sudden cardiac death]]. In case of significant LVOT obstruction, medical treatment is indicated, but it’s not certain whether medical treatment is indicated for HCM without significant LVOT obstruction. Medical treatment includes [[Beta blocker|beta blockers]], [[Calcium channel blocker|CCBs]], and [[Antiarrhythmic drug|antiarrhythmic drugs]].
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Procedures to reduce the size of the septum may also be used, and include surgical septal myectomy, and the use of alcohol to ablate the septum. Heart transplant is a last-line option.
Procedures to reduce the size of the septum may also be used, and include surgical septal myectomy, and the use of alcohol to ablate the septum. Heart transplant is a last-line option.
<noinclude>
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Internal Medicine (POTE course)]]
[[Category:Internal Medicine (POTE course)]]
‎</noinclude>