Hypertrophic cardiomyopathy Flashcards
In hypertrophic cardiomyopathy the sarcomeres are added in ________
Parallel which increases thickness and contractility.
In HCOM the _____ thickness greater than _______-
Interventricular septum > free wall.
What is the effect of thickening of the interventricular septum in HCOM ?
Less diastolic filling and poor stretching of the cardiac muscles leading to reduced SV and diastolic heart failure or HfPEF.
What is systolic anterior motion of the mitral valve seen in HCOM ?
LVOTO is caused by fast-flowing blood through the LV outflow tract which pulls the mitral valve anteriorly (towards the LV outflow tract) due to a Venturi effect. This is known as systolic anterior motion (SAM) of the mitral valve.
What is the characteristic of murmur in HCOM ?
Crescendo - decrescendo due to the blood spraying through the LVOTO.
What is the manure to reduce the intensity of the HCOM murmur ?
Squatting or handgrip which will actually increase the pressure within the ventricle and reduce LVOTO leading to reduction in the intensity of murmur.
What is the classical pulse patten seen in HCOM ?
Biffid pulse.
What is the pathological heart sound heard in HCOM ?
S4
What is the age group and symptoms of HCOM ?
Dyspnea, syncope, and sudden death seen in young patients often associated to exercise.
What is the genetics of HCOM ?
Autosomal dominat Missens mutation that affect the beta myosin heavy chain, myosin binding protein C, and Troponin T.
What is the histological hallmark of HCOM ?
Myocyte disarray.
What is the genetic condition associated to HCOM ?
Frederick’s ataxia
What is the medication contraindicated in HCOM ?
Digoxin as it increases the force of contraction.
What are the medications used in HCOM ?
- Beta blockers and calcium channel blockers.
What is the most effective management of HCOM ?
Surgical septal reduction.
