AHA HCM 2020 Flashcards
what is 30 day mortality for septal reduction and myomectomy?
1%
What is major adverse effect rate for Myomectomy and ETOH reduction?
10%
Rate of PPM for CHB for Myomectomy and ETOH reduction?
5% myomectomy
10% ETOH
Name 4 phenocopies of HCM?
- Infiltrative (Amyloid)
- Fabry’s disease
- Glycogen Storage disorders
- Freidrich Ataxia
How to screen FDRs for HCM and how often?
Adults:
-At time of diagnosis in proband and then every 3-5 years.
Children and Adolescents:
- 1-2y: If Genotype + or early disease in proband
- 2-3y: All others
How often to repeat echo in HCM?
Every 1-2 years
Who to perform stress echo in?
if resting and echo with provocative manouvre echo is still less than LVOT < 50mmhg
What is recommended for imaging during ETOH ablation?
-TEE with US enhancing contrast injection of the candidate’s septal perforators
4 reasons for CMR in HCM?
- If echo inconclusive for diagnosis
- Alternative causes (Fabrys, Amyloid, Athletes heart)
- Scar burden if no other reason for ICD
- To plan for selection of SRT
How extensive should family history be on initial assessment?
3 generations
Class 1 indication for HCM?
SCD/VT/VF
5 Class 2a recommendations for ICD?
- FH SCD
- Massive LVH (> 30)
- Unexplained Syncope
- Apical Aneurysm
- EF < 50%
2 Class 2b for ICD?
NSVT
LGE on CMR
Indications for septal reduction therapy (3 things)
Severely symptomatic despite OMT at experienced centers
When is myomectomy preferred over ETOH ablation?
Associated disease needing surgery
How long to have SCAF to anticoagulation?
> 24 hours duration
3 indications for Cath in HCM?
- Prior to SRT
- Symptoms of angina/evidence of ischemia
- To quantify LVOT gradient when uncertainty in degree of obstruction
What to do if genotype positive identified in HCM case? What if not identified?
+ Test FDRs for that gene
- Clinical surveillance in FDRs (1-2 years in children, 3-5 years in adults)
After beta blockers/CCB’s, what are 4 AADs that can be used in HCM?
- Amiodarone
- Sotalol
- Dofetilide
- Mexiletene
When to initiate GDMT for HCM with LV dysfunction?
-LVEF < 50% (Also DC Disopyramide, CCB and consider ICD (2a))
When to order CPET in patients with HCM?
NYHA III/IV or refractory arrhythmias -> transplant considerations
Name 4 meds that can be used for rhythm control of AF in HoCM
- Disopyarmide (First line)
- Amiodarone (Reasonable)
- Sotalol (Reasonable)
- Dofetilide (Reasonable)
What are three AADs that can be used for Ventricular Arrhythmias?
Amiodarone
Sotalol
Mexiletene
What are three things that weight loss in HoCM can result in improvement?
- AF
- LVOTO
- HF symptoms
