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Hypertrophic cardiomyopathy/Obstructive cardiomyopathy Anita Deane - - PowerPoint PPT Presentation
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
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Apical HCM
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Apical HCM
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Lateral/Inferior wall HCM
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Lat/Inf wall HCM
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HOCM – Hypertrophic obstructive cardiomyopathy
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HOCM
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HOCM
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HOCM
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HOCM
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HOCM
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HOCM
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HOCM
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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%.
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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
- bstruction.
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Mimics
- LVOT obstructive
gradient is seen in late systole.
- Mitral regurgitation is
seen from from early systole.
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Other echo features
- Elongated MV leaflets sometimes seen
- Diastolic dysfunction.
- Dilated left atrium.
- Over time LV systolic impairment.
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Screening/Follow up? Treatment?
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