Hypertrophic Cardiomyopathy

Question 1

Most Common Type

Answer 1

Concentric

Question 2

Hypertrophic Cardiomyopathy Definition

Answer 2

Abnormal myocardial thickening that is inappropriate, often asymmetrical, and occurs in absence of stimulus for hypertrophy (like HTN or AS)

Question 3

Physical Exam 3 Signs

Answer 3

Bifid pulse
Harsh systolic murmur head b/w apex and L sternal border (usually doesn’t really radiate)
Murmur decreases w/ squatting and increases w/ standing

Question 4

2 Misdiagnoses

Answer 4

Murmur sounds like AS

Symptoms sound like CAD (dizziness, syncope, dyspnea, etc)

Question 5

EKG Benefit/Downside

Answer 5

Sensitive but not specific

Question 6

2 Immediate Medical Interventions

Answer 6

BBs and Nondihydropyridines (verapamil/diltiazem)

Question 7

Implantable Defib Use

Answer 7

Reduce sudden cardiac death from malignant ventricular arrhythmias

Question 8

3 Surgical Interventions

Answer 8

Morrow Procedure: LV Septal Myotomy-Myectomy (resection of hypertrophic septum)
Mitral Valve Replacement
Orthotopic Heart Transplantation

Question 9

Nonsurgical Septal Reduction (& outcome)

Answer 9

Alcohol Septal Ablation - cath a coronary going to part of septum that’s blocking flow, give it a few Everclear shots (after making Ronak do some), and cause a controlled infarction/reduction at that site. Doesn’t reduce death risk, just increases QoL

Question 10

Genetic Muts

Answer 10

Usually AD sarcomere machinery muts like myosin or troponin. Can’t tell which are higher death risks though

Question 11

3 Differential Diagnoses

Answer 11

Cardiac Loading (AS, HTN)
Athlete's Heart - crazy ultramarathoners and shit
Infiltrative Processes like Amyloidosis/Fabry's Disease

Question 12

5 Sudden Death Predictors

Answer 12

Septal Thickness
FH of Sudden Death
Syncope
BP drop w/ exercise
Vtach