Hypertrophic cardiomyopathy/Obstructive cardiomyopathy Anita Deane - PowerPoint PPT Presentation

Hypertrophic cardiomyopathy/Obstructive cardiomyopathy Anita Deane Snr Cardiac Physiologist

Apical HCM

Apical HCM

Apical HCM

Lateral/Inferior wall HCM

Lat/Inf wall HCM

HOCM – Hypertrophic obstructive cardiomyopathy

HOCM

HOCM

HOCM

HOCM

HOCM

HOCM

HOCM

HCM prevalence • Common inherited cardiovascular disease. • HCM, 1:500 prevalence in general population. • HCM most common cause of SCD in young people, (<35 years) and athletes. • Autosomal dominant, child has 50% chance of inheritance. • Alterations of MYH7 and MYBPC3 a/c for >80%.

LVOT obstruction Valsalva manoeuvre can alter loading conditions and contractile state of the heart. However, this underestimates gradients compared with exercise, 40% sensitive in predicting exercise induced gradients. Exercise is the most physiological and sensitive method for detecting provocable LVOT obstruction.

Mimics • LVOT obstructive gradient is seen in late systole. • Mitral regurgitation is seen from from early systole.

Other echo features • Elongated MV leaflets sometimes seen • Diastolic dysfunction. • Dilated left atrium. • Over time LV systolic impairment.

Screening/Follow up? Treatment?

Thank you, any questions?