HOCM

Question 1

HOCM on echocardiogram

Answer 1

Asymmetric septal hypertrophy and systolic anterior movement (SAM) of the anterior leaflet of mitral valve on echocardiogram or MR support HOCM

Question 2

Genetic inheritance pattern

Answer 2

Autosomal dominant

Question 3

Prevalance of HOCM

Answer 3

1 in 500

Question 4

Pathophysiology

Answer 4

the most common defects involve a mutation in the gene encoding β-myosin heavy chain protein or myosin-binding protein C
results in predominantly diastolic dysfunction
left ventricle hypertrophy → decreased compliance → decreased cardiac output
characterized by myofibrillar hypertrophy with chaotic and disorganized fashion myocytes (‘disarray’) and fibrosis on biopsy

Question 5

Features of HOCM

Answer 5

Asymptomatic
Exertional dyspnoea
Angina 
Syncope- following exercise
Sudden death- ventricular arrhythmias
Jerky pulse- a waves- double apex beat 
EJECTION SYSTOLIC

Question 6

Echo finding of HOCM

Answer 6

Echo findings - mnemonic - MR SAM ASH
mitral regurgitation (MR)
systolic anterior motion (SAM) of the anterior mitral valve leaflet
asymmetric hypertrophy (ASH)

Question 7

ECG of HOCM

Answer 7

ECG
left ventricular hypertrophy
non-specific ST segment and T-wave abnormalities, progressive T wave inversion may be seen
deep Q waves
atrial fibrillation may occasionally be seen