Hypertrophic cardiomyopathy

Question 1

What is the pathophysiology of HCM?

Answer 1

Inheritance of mutations in multiple genes for sacromeres causes disorganised cellular architecture that predisposes the patient to get abnormal signal transmission and arrhythmias

Question 2

How does HCM present clinically?

Answer 2

Symptoms of pulmonary congestion

Chest pain

Palpitations

Presyncope

Question 3

What type of murmur might you hear in a patient with HCM? What can you get the patient to do to increase its volume?

Answer 3

Late systolic murmur at the lower left sternal edge and apex

MR

S4

Valsalva

Question 4

What findings are made on Ix?

Answer 4

ECG

• “Dagger” Q waves in lateral leads
• LVH

Cardiac hypertrophy on imaging

Question 5

What is HCM?

Answer 5

Hypertrophic cardiomyopathy (formerly hypertrophic obstructive cardiomyopathy) is a common inherited cardiac disorder of abnormal cardiac hypertrophy that can cause sudden death