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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> | |||