Cardiomyopathy

Question 1

Hypertrophic cardiomyopathy

Answer 1

Subvalvular left ventricular outflow obstruction from septal muscle hypertrophy

Question 2

Physiologic effects of hypertrophic cardiomyopathy on mitral valve

Answer 2

abnormally high blood velocity –> Venturi effect on the anterior leaflet of the mitral valve –> Systolic anterior motion (SAM)

Question 3

Alternative to open surgery for Hypertrophic cardiomyopathy

Answer 3

1. Dual chamber ventricular pacing

2. Alcohol septal ablation of the first septal perforator artery of the LAD

Question 4

Indication for surgical intervention (4)

Answer 4

1. Transvalvular gradient of 50 mmHg
2. Provokable gradient of 60 mmHg
3. Asymmetric thickness of interventriclar septum >1.5 cm
4. Pacemaker is required in approximately 10%