Hypertrophic Cardiomyopathy

Question 1

MOST COMMON CAUSE OF DEATH IN YOUNG PEOPLE

Question 2

Epidemiology

Answer 2

Younger
Male (<50 years)

Question 3

Risk factors

Answer 3

Family history of cardiomyopathy
High blood pressure
Obesity
Diabetes
Previous MI

Question 4

Aetiology

Answer 4

• Familial (inherited autosomal dominant mutation) of sarcomere proteins troponin T, myosin B
• 50% sporadic

Question 5

Pathophysiology

Answer 5

Left ventricular outflow obstruction from asymmetric septal hypertrophy = effecting the mechanical or electrical function of the heart
All in the absence of hypertension + valvular disease
Results in reduced cardiac output

Question 6

Symptoms

Answer 6

Sudden death may be first presentation
Angina
Dyspnoea
Palpitations
Syncope

Question 7

Signs

Answer 7

Harsh Ejection-systolic murmur
Jerky carotid pulse
A wave in JVP
Double apex beat
Systolic thrill at lower left sternal edge

Question 8

Diagnosis

Answer 8

ECG
- T wave inversion
- deep Q waves
(Inferior and lateral leads)
GOLD STANDARD = ECHO
- asymmetrical septal hypertrophy
- small LV cavity with hyper contractile posterior wall
Genetic testing

Question 9

Treatment

Answer 9

Anti-arrhythmic = Amiodarone
CCB - Verapimil
Beta-blocker - Atenonol